Grandma Cancer Alert: Too Many Young Women and Young Mothers with Breast Cancer

Women have been educated to know risk factors for breast cancer.  Here is information from the Young Survival Coalition, Young Women Facing Breast Cancer Together:

Breast cancer in mothersFamily history and genetics are two risk factors for breast cancer. While researchers continue to search for the definite causes of breast cancer, some consider young women at high risk for breast cancer if they have either or both:

          • a strong family history of breast or ovarian cancer. This could mean two or more relatives with breast or ovarian cancer, a relative with both breast and ovarian cancer, a male relative with breast cancer or a relative diagnosed at a young age with breast cancer.
          • genetic mutations associated with breast cancer. These include mutations to the BRCA1 and BRCA2 genes that normally help control cell division. 

Some young women who know they have the above risk factors have chosen to have mastectomies and ovaries removed after freezing eggs.  We hear young women are choosing this route as early as age eighteen.

Now here is what my daughters and I are seeing that we did not know.

It is too painful to share the personal knowledge of the stories of close family friends who have breast cancer.  It is more than too painful to share the personal knowledge of the stories of the daughters of close family friends who, as young women and young mothers, have breast cancer.  Some young women did not have any of the above risk factors.  Some young women did not know they had the above risk factors.

My daughters and I have discussed this frightening phenomenon.  My daughters and I think there are more young women, especially young mothers, with breast cancer than us Boomer women with breast cancer.  The statistics we hear about seem to tell us otherwise. But, we know people and people who know people and those people who know people.  Too many young women with breast cancer.  Too many young mothers with breast cancer.

I personally think that the hormones fed to animals which mimic estrogen when milk, etc. have been ingested is one of the causes for this younger generation.  Our grandchildren drink organic for the most part.  Maybe it’s the plastics we heated in the microwave.  We now know better.  Maybe it’s environmental.  Maybe the environmental causes have activated the dormant breast cancer cells that would not otherwise have been activated.  Who knows.  I do not know the studies.  I know people and people who know people and those people who know people.  And it seems, the young women are younger and younger at onset of breast cancer.

ALERT NUMBER 1: WITHIN TWO YEARS OF GIVING BIRTH

We continue to hear that breastfeeding protects moms from breast cancer and being breast fed lowers the risk too.  See, press release May 2012, from the American Institute for Cancer Research: http://www.aicr.org/press/press-releases/breastfeeding-protects-moms.html   Our personal knowledge of young mothers with newly diagnosed breast cancers is too many.  I read on the web that those cancers were most likely there for a while.  Could childbirth temporarily increase the risk of activating or releasing dormant breast cancer cells?

Maybe the issue is YOUNG, younger than we expect for the young women we know.  Read WebMD: http://www.webmd.com/breast-cancer/features/i-am-too-young-to-get-breast-cancer   Read the following from: http://www.youngsurvival.org/breast-cancer-in-young-women/overview/

Young women CAN and DO get breast cancer. It is estimated that more than 250,000 women diagnosed with breast cancer at age 40 or younger are living in the U.S. today. More than 13,000 young women will be diagnosed this year. While breast cancer in young women accounts for a small percentage of all breast cancer cases, the impact of the disease is significant. 

If you know a young mother within two years of giving birth, please recommend that they speak to their doctor about having a mammogram AND ultrasound as soon as medically available where breastfeeding will not make these possible.   Breast cancer diagnoses in mothers who breastfed, in particular, within two years of birth of a child is what we have been hearing is happening too often.

ALERT NUMBER 2: WITH A FATHER WHO HAS OR HAS HAD PROSTATE CANCER

If you know a young mother or a young woman whose father has or has had prostate cancer, please recommend that they speak to their doctor about having a mammogram AND ultrasound as soon as medically possible.   We are hearing there is a connection between father with prostate cancer and daughter at risk of breast cancer.

ALERT NUMBER 3: ONE MAMMOGRAM BETWEEN AGES 35 AND 40 SHOULD BE COVERED BY INSURANCE

Mammograms are first recommended at age 40 or age 50.  We are told that most breast cancers occur well beyond a women’s 40s.  Maybe that is why insurance companies want us to delay in getting a first mammogram.  However, we hear that some insurance companies cover one mammogram, called a “base line” between ages 35 and 40.  Have all the young women in your life have a first mammogram earlier rather than later.  If covered or affordable, consider an ultrasound too.

This blog entry was written before this Grandma saw the NBC Nightly News on Tuesday, February 26, 2013 where Dr. Nancy Snyderman, NBC News Chief Medical Editor reported on a new study that breast cancer is up for young women!  Experts are concerned as they do not know why.  Dr. Snyderman mentioned early puberty, weight, or even environmental conditions as possible causes.  See: http://vitals.nbcnews.com/_news/2013/02/26/17104479-aggressive-breast-cancer-in-more-young-women-study-finds?lite?ocid=twitter  Maggie Fox, Senior Writer, NBC News, writes on the NBC website reporting on the study:

“[m]ore young women are being diagnosed with advanced breast cancer, doctors reported on Tuesday. It is a very small increase in a group of people who only rarely develop cancer, but it’s significant enough to have experts asking why. The biggest increase was seen in women aged 25 to 34. It’s bad news because when women are diagnosed this young, usually the cancer is more aggressive, there’s no good way to screen for it and because there is no cure, even if the women can control it they face decades of life as breast cancer patients.  Typical of breast cancer in younger women: It grows faster, spreads more quickly, and is harder to treat. While the five-year survival rate for breast cancer that has not spread is 93 percent, for women 39 and under whose cancer has spread, it’s only 31 percent.

Dr. Rebecca Johnson of Seattle Children’s Hospital and University of Washington in Seattle was working with a cancer nonprofit, Critical Mass: The Young Adult Cancer Alliance and wanted to see if there were any differences in rates of cancer for young adults. Johnson, a pediatric oncologist and breast cancer survivor herself, looked at National Cancer Institute data from 1973 to 2009. She and colleagues broke it down by age, ethnic group, diagnosis and other factors.

They found a steady increase starting in 1976 of breast cancer that had spread out of the breast among 25- to 39-year-old women. The rate went from 1.53 per 100,000 women in 1976 to 2.9 per 100,000 women in 2009, Johnson and colleagues wrote in their report in the Journal of the American Medical Association. That represents an average increase of just 2.07 percent per year, a relatively small rise, but it shows no signs of abating, the authors noted.  “This change translates into a tripling of the incidence of metastatic breast cancer over the 34-year period,” Johnson told NBC News. “In 1975, our projections show there were about 250 cases per year of metastatic breast cancer in young adult women. In 2009, it was about 800.”

The study looks only at data, and Johnson isn’t sure of why the cases might be increasing. It’s not more or better screening –women this young are not routinely screened for breast cancer. She also doesn’t believe doctors are finding more cases because they are trying harder to see if the cancer has spread in these young women.

“If that was the case, then it would be like a pie, with a larger piece of the pie being distal disease,” Johnson said. “But there’s been no decrease in any other stage of breast cancer.’

Obesity is a risk factor for breast cancer in middle-aged women and that’s worth more study, Johnson says. But she notes that obesity actually lowers the risk of breast cancer among the youngest women. Some studies have suggested a combination of obesity, a lack of exercise and overeating may raise the risk and that’s worth looking at, she says.

It is possible chemicals could somehow be a cause. There are also theories that viruses may be involved — a virus causes cervical cancer and head and neck cancer, for instance.

Dr. Sandra Swain, a breast cancer specialist at Washington Hospital Center in Washington D.C. and president of the American Society of Clinical Oncology, says women are putting off pregnancy longer and that could have an effect.  “Having kids younger decreases the risk of breast cancer by half,” she says.

Swain also believes higher rates of obesity may be a factor. She stresses that the results should be confirmed in larger studies, and says even if they are confirmed, the findings are not a cause for panic.

“There’s actually a decrease in mortality, especially in younger women, probably because our treatments are better,” Swain says. . . .[T]he Food and Drug Administration approved just last week – Kadcyla — which combines a strong chemotherapy drug with Herceptin, a genetically engineered immune system protein that homes in on tumor cells. . . .   Breast cancer is the second largest killer of U.S. women, after lung cancer. It will be diagnosed in about 235,000 U.S. men and women this year and will kill 40,000, according to the American Cancer Society.

The risk goes up with age. About one in eight cases of invasive breast cancer are found in women under 45. Less than 1 percent — 0.43 percent — of women aged 30 will develop breast cancer within the next 10 years, and only 4 percent will get it by age 70. About 35 out of every 1,000 women now aged 60 will develop breast cancer over the next 10 years, according to the Centers for Disease Control and Prevention.

Johnson, the researcher, is now 44. She was one of the luckier young survivors of breast cancer. She was diagnosed at 27 and her tumor had not spread beyond the breast. She found a lump by chance and waited several months before she had it checked. “I was super-busy,” she said. So her advice to young women? “If there’s a general take-home message it would just be for awareness. If you find a breast lump, you need to know that breast cancer can happen,” she said.

Dr. Snyderman said, on the NBC News, that beast examination is the best method for diagnosis and that age 50 is the time for a mammogram.  This Grandma does not agree.  This Grandma is not a doctor but an observer of real life.   A base line mammogram at age 35 is what this Grandma recommends.

For those of us with young grandchildren, we Grandmas feel the pain of those young mothers with breast cancer and pain of the mothers of those young mothers.

With a heavy heart,

Mema

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