In recent years, medical experts have seen a troubling rise in cases of breast cancer among women under the age of 50. But experts say there are many things you can do to help lower your risk, from visiting your health practitioner more frequently and asking for mammograms sooner to conducting breast exams at home.
To understand more about this important topic affecting young women, we chatted with Dr. Ronald Hirth, Hilltop OB GYN, to find out possible reasons why breast cancer is becoming more common in young women and actionable things women can do to keep on top of their breast health.
Breast Cancer is on the Rise in Young Women
In women under the age of 50, medical experts have seen an uptick in cases, but thankfully breast cancer cases under the age of 40 remain very rare. “Some of these cases are likely due to increased diagnosis from more frequent and better screening options,” Hirth says. So, there might not necessarily be an increase in cases per se. “Otherwise, no one really knows why this is occurring. There seems to be an increase in colon cancer in people in their 40s, as well. It would be nice to know if these are early cancers that are mostly being caught by screening, but that information is not available either.”
What doctors do know is that when women are diagnosed with breast cancer under the age of 50, the cancer is usually more aggressive. “That doesn’t mean that all hope is lost or that there is no treatment available,” Hirth says. “Breast cancer in general is very treatable and usually the treatments are relatively well tolerated.”
So, definitely don’t ignore any abnormalities you might find during a self-exam, he says. “Get it checked out to make sure you stay healthy for yourself and your loved ones.”
The Importance of Breast Self-Exams
Women under the age of 40 should be performing a monthly physical examination to assess the breasts for any masses or skin changes. It is also important to examine both armpits to ensure there are no enlarged lymph nodes.
“Proponents of the exam tend to point out that women finding an abnormality in their breast will likely lead to earlier diagnosis than waiting for a screening test like a mammogram,” Hirth says.
What to Look for When Examining
Hirth believes patients should become familiar with their own breasts, as well as the signs and symptoms of breast cancer. These may include:
- masses or lumps
- skin changes
- breast pain
- an inverted nipple
- spontaneous nipple discharge that is clear or bloody and isolated to one breast.
Check your breasts after your period. “If you are menstruating, the breast self-exam is best done when your breasts are least lumpy, which is a few days after your period,” Hirth says. This is because breasts are hormonally responsive, so sometimes the tissue will swell during the second half of your cycle.
“In addition, if you are young and of average risk, you might decide to follow a soft lump for a few cycles to ensure it resolves on its own.” Most of these lumps are actually cysts and will go away. This does not apply to women in menopause, who should report any new lumps right away.
Of course, it is never wrong to make an appointment for any breast changes. “Most young women who come to my office have a small pimple or cyst and are reassured right away,” Hirth says.
When to See a Doctor
For screening purposes, Hirth says all women should have a clinical breast exam every one to three years starting in their early 20s, or when they become pregnant. “Women of average risk should start mammograms at 40 years old, and then have them at least every other year until 75 years old,” Hirth says.
But some women are at higher risk for breast cancer. The women at the highest risk have a genetic mutation called BRCA. This mutation confers a lifetime risk of 60-80% for breast cancer. This is why, if you have a family history of breast or ovarian cancer, you should speak with your provider about being tested for this mutation.
Women who have dense breasts can “hide” breast cancer on mammograms, Hirth warns. “These women who are at higher risk may be offered different screening or diagnostic imaging, biopsies, medication or even surgery to decrease their future risk of breast cancer,” he says. A patient who is still having a menstrual cycle should see their provider if they have breast changes that are persistent over a cycle or two. Postmenopausal women should report any changes right away. “Remember the risk of breast cancer continues to increase with age,” Hirth says.
