Despite huge leaps in breast cancer treatment over the last two decades, diagnoses of the disease continue to increase, and at a faster annual rate of late, 1.7%, among younger women. That translates to thousands of new breast cancer cases each year.
Dr. Lucy Wallace of Baylor Scott & White and Texas Oncology specializes in breast surgical oncology. She said no one knows the exact cause for the increase, but several reasons are suspected.
Dr. Wallace: You know, the first would be a genetic component. About 6% of breast cancer patients carry a BRCA mutation. Among young breast cancer patients, that number is double.
There are also lifestyle factors that may contribute. Alcohol consumption among young people has been increasing, and alcohol is known to be a risk factor for breast cancer.
Also, obesity is on the rise, and obesity is a known risk factor for breast cancer as well as for breast cancer recurrence.
And finally, there are some environmental factors that may come into play.
There's been a lot of attention to microplastics lately. Some studies suggest that women who are in their 30s and 40s now grew up in an environment where plastic water bottles and plastic food storage containers, having chemicals in them such as BPA . Teflon pans and. Other household chemicals were commonly used when this cohort of women were coming into their 30s and 40s.
Baker: Do we know that for a fact in terms of environmental exposures?
Dr. Wallace: It's highly suspected, but these are proposed ideas that have been kind of put into the literature and are still under investigation.
Baker: By the way, when we talk about younger women, we mean, what, younger than 50?
Dr. Wallace: In general, most sources cite younger than 50, yes, as a younger woman, presumed to be premenopausal.
Now, some of our statistics focus on women under 40 because that is a group of women who are not accessing screening tools yet. And so, you know, it's important to focus on that group separately, I think.
Baker: The forms of breast cancer tend to be more aggressive among younger women, why is that?
Dr. Wallace: Part of that has to do with the increased prevalence of BRCA mutations in younger patients. So we know cancers associated with BRCA mutations tend to be more aggressive. But other proposed ideas are that women who are under 40 or younger women in their 20s and 30s, if they feel a lump, they may just assume it's nothing. Breast cancer really isn't on the radar at that age. Um, and so lumps that are palpated by a woman may not be addressed in a timely fashion, you know, leading these cancers to be diagnosed at a later stage. But it is true. Um, we don't know all of the reasons why, but, you know, younger women do present with larger tumors. They do tend to present with higher grade tumors, meaning tumors that are growing faster, um, and they also tend to come in with lymph node involvement. In comparison to their older counterparts.
Baker: All of this said, what could be done to address this problem?
Dr. Wallace: I mean, still the most effective tool we have again is early detection. So I believe only about 62% of women in Texas participate in annual screening mammography. So I think if we could increase that number to 100%, it would be ideal.
Average-risk women should begin doing screening mammograms every year at age 40 and don't skip a year.
And then before the age of 40, women should still practice what we call breast self-awareness. So be aware of your own breast texture, lumps and bumps, and notify your physician if you feel a change.
And then again, knowing your family history, talking to your family members. Some family members don't share this information readily, but it's so important to know if you have a history of breast and certain other cancers, again, certain biopsy results that may convey an increased risk for breast cancer. And then putting yourself in that risk model, taking advantage of all the enhanced screening measures that are available. That's really what we can do now.
RESOURCES:
5 Facts About Breast Cancer in Younger Women
Breast Cancer Increasing Among Younger Women, Latest Data Show
