News Heightened risk of breast cancer in younger women

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Rise in risk of breast cancer in younger women

The number of younger women diagnosed with advanced, metastatic breast cancer has increased over the past three decades, as revealed by new research published in The Journal of the American Medical Association.

The researchers, led by Dr Rebecca Johnson at Seattle Children’s Hospital and the University of Washington, stress there is no cause for alarm as the overall incidence of cancer in the group remains small – with one in 173 women developing breast cancer before turning 40.

The team found the rate of metastatic breast cancer – the type that spreads to other organs in the body – increased by approximately two per cent annually between 1976 and 2009 in younger women.

“We think that the likelihood is that since this change has been so marked over just a couple of decades, that it’s something external, a modifiable lifestyle-related risk factor or perhaps an environmental toxic exposure, but we don’t know what,” Johnson said.

She further speculated overeating, lack of exercise or the use of hormonal birth control could play a role in the rising incidence of metastatic breast cancer in younger people. Dr. Johnson is also pushing for more research investigating the health effects of hormones in meat and plastic in drinking bottles.

The research used data from cancer registries run by the National Cancer Institute to analyse diagnostic trends. Predictably the researchers found a heightened rate of breast cancer diagnosis in middle-aged and older women, a phenomenon explained by widespread screening. More ambiguously, for women aged 25 to 39 diagnoses of metastatic breast cancer – spreading to the bones, brain or lungs –rose from one in 65,000 in 1976 to one in 34,000 in 2009.

Although metastatic cancer generally has a cruel prognosis – with less than one-third of women surviving at least five years after diagnosis – the report specified the type of metastatic cancers seen in younger women were mostly sensitive to estrogen. This factor was described as ‘comparatively fortunate’ as these cancers are often more responsive to treatment and offer a longer average survival rate.

Surgeon Dr. Julie Margenthaler of the Washington University School of Medicine in St. Louis who has also studied breast cancer in younger women said the new research was limited, as it did not incorporate information on women’s family history.

“It is intriguing data, but I think that it’s going to have to be validated in some other datasets,” said Margenthaler, who was not involved in the research.

Dr Johnson agrees the findings should trigger further research and reassures women there is no need to panic.

“We’re certainly not advocating any changes in screening mammography practices. This is an increase, but it’s small on a population level,” she said.

“There’s no reason that because you’re 35 and see this report, you need to go out and get a mammogram right away.”

How to do a self breast exam

It is critical every woman knows how to do breast self-examination. As of age 20, it should be a monthly routine:

• Most doctors recommend lying down with one arm behind your head. With the other hand, feel each breast with your middle three fingers for any irregular lumps, cyst-like formations, thickening or unusual dimpling. Be sure to feel the entire breast area – from the top of the chest, under each arm, around the breast mound and down towards the rib cage.

• You can also look at your breasts in the mirror, both with your hands on your hips and in the air. Check for changes in colour, shape, nipple location, dimpling or anything that is irregular.

• Use your thumb and forefinger to gently press the nipple and check for any irregular discharge.

• It is not a cause for panic if you do come across an anomaly – 80 per cent of lumps turn out to be benign – but you should consult with your doctor as soon as possible to be sure.

• For pre-menopausal women especially, aim to perform the self-exam at the same time each month, ideally after your period. As your breasts change as you go through your menstrual cycle, by examining them at the same point in your cycle, you can make a more accurate comparison.

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