Advanced breast cancer surges slightly in young women

Story by Jamie Lampros
(Standard-Examiner correspondent)
Wed, May 15, 2013
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By JAMIE LAMPROS

Standard-Examiner correspondent

Advanced breast cancer among younger women has increased slightly over the last three decades, leaving researchers scratching their heads as to the reason.

According to an article published earlier this year in the Journal of the American Medical Association, researchers found a small increase in advanced breast cancer in women ages 25 to 39. The study, conducted by Seattle Children’s Hospital, found that advanced cases climbed to 2.9 per 100,000 younger women in 2009, from 1.53 per 100,000 women in 1976.

Though small, the increase is worrisome, according to the researchers, because the cancer had spread to organs such as the liver and lungs by the time it was discovered.

Dr. Jose Perez Tamayo, medical director of women’s imaging services at Ogden Regional Medical Center and Lakeview Hospital, said advanced cases of breast cancer are often aggressive cancers that can spread to bones and other organs — and are more often fatal.

“While some experts question whether the numbers reflect an actual increase in the incidence of breast cancer in young women, others are investigating the effects of other factors (that) may increase the risk of breast cancer in young women,” he said.

Those factors include genetic mutations, childhood obesity, environmental exposure to toxic chemicals, diet and alcohol use, and delayed childbearing.

“Despite the information provided by this recent study in JAMA, the chances of a young woman developing breast cancer is still very low,” he said. “The evidence does not support screening mammograms for women before age 40 if there is not a significant family history of breast or ovarian cancer.”

Dr. Catherine Babcook, medical director of breast imaging at McKay-Dee Hospital, said her youngest breast cancer patient was 17 years old. Although breast cancer can occur at any age, Babcook said, it is not common enough in women younger than 40 to justify the cost of screening the large number of women who fall into this younger age group.

Dr. Jason Stinnett, a hematologist and oncologist at Utah Cancer Specialists, said the study was not designed to see why there has been an increase, although he suggests the increase may be due to improved imaging technology — which is diagnosing more patients in this age group with cancers that have spread.

All three physicians say self-awareness through monthly self-exams and yearly checkups are essential. Any changes in the breast should be immediately reported to your physician.

“I encourage all women to become familiar with the texture of their own breast tissue,” Babcook said. “There isn’t anything magic about it. As a physician, there is nothing special about my hands or my ability to do a breast exam.

“It is practice and familiarity, and women can get to know their own breast tissue better than anyone else and be able to notice a change and bring that change to their doctor’s attention for further evaluation.”

Tamayo said the single most important way to avoid breast cancer is to know your family history.

A family history that includes close relatives with premenopausal breast cancer, ovarian cancer, breast cancer in multiple relatives, or breast cancer in a close male relative may indicate a genetic mutation that can raise the risk of breast cancer to greater than 80 percent and ovarian cancer to 50 percent.

In addition, lose weight if warranted and don’t abuse alcohol and tobacco products, the doctors said.

“There are a few studies which show drinking more than two glasses of alcohol a day can increase risk,” said Stinnett. “Women who had radiation treatments for other types of cancer such as lymphoma while in their teenage years or twenties can have a higher risk for breast cancer and should begin screening earlier.”

Stinnett said it’s important to note that breast implants, wearing certain types of bras, and using antiperspirants have NOT been linked to breast cancer.

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