Breast Cancer: Why Your 20s Isn't Too Young to Talk to A Doc About It

October is Breast Cancer Awareness month. Time to break out your pink ribbons. And also to read up on how to fight the disease with proactive knowledge. We talked to Dr. Toma Omofoye, an associate professor of radiology specializing in breast imaging at MD Anderson Cancer Center, to help us with that part.

What do I need to know?

 Breast cancer is the second most common cancer in women in the U.S.— skin cancer gets the (worst ever) first prize. There is about a 13% chance, or 1 in 8, that a woman will get breast cancer in her lifetime. It’s also the second-leading cause of cancer death in women. Btw: Men can also get breast cancer. “Anybody with breasts can get breast cancer,” Dr. Omofoye said. And it’s diagnosed in about one in 800 men.

 But I’m youngish. I’m fine, right? 

 It depends. Age does increase a woman’s risk for breast cancer. But Dr. Omofoye emphasizes that about 9% of women diagnosed are under 45. And that there are certain groups of women at a higher risk of developing breast cancer. 

 What would put me at higher risk? 

• Family history and genetics…If you have one grandmother who got breast cancer at 75, you don’t need to worry more than the average woman. But if you have one or more family members diagnosed under 50, your doctor may recommend genetic testing for mutations in the genes associated with a high risk of breast cancer, BRCA1 and BRCA2. More on that later. And Black women, women of African descent, and women who are of Ashkenazi Jewish descent are more likely to be diagnosed with breast cancer while they’re young, Dr. Omofoye said. 

• Breast tissue density...Yes, this is a thing. And no, it has nothing to do with cup size. Having “dense breasts” — or a high amount of glandular and fibrous tissue versus fatty tissue in the breasts — can put you at higher risk of getting breast cancer. It also makes it harder to detect the disease. Almost half of women over 40 who get mammograms find out they have dense breasts. But thing to know: It’s hard to tell if your breasts are denser than average before you get a mammogram, Dr. Omofoye said.

• Radiation therapy...If you’ve undergone radiation therapy on your chest before age 30, which is common for treating diseases like Hodgkin’s lymphoma, you’re more likely to get breast cancer.  

• Reproductive health history...Getting your period before age 11 or going into menopause on the later side could put you at a higher risk of developing breast cancer later on, Dr. Omofoye said. But being pregnant before age 30 decreases risk, because of the hormones involved in supporting the pregnancy.

What measures should I be taking? 

 While it’s uncommon for women under 40 to get breast cancer, proactive prevention can start earlier. Here’s a timeline that Dr. Omofoye recommends:

• Age 25-30: Talk to your OB-GYN or PCP about your personal breast cancer risk. That chat can include info about your family history with cancer, and might include a computer algorithm your doctor can use to assess your risk level, Dr. Omofoye said. Note: 12% is average. If your percentage is above that, your doctor could recommend further screenings.

• Age 40: If you’re of average risk, start annual mammogram screenings for breast cancer. Although different professional cancer orgs can differ in their ages and guidelines, Dr. Omofoye said data supports starting screening mammography by this age, or sooner if your risk level is higher.

• Right now, whatever your age: Get to know your breasts. “Before a shower or after a shower, stand and look at your breasts in the mirror,” she said. Pay attention to whether your breasts are close to mirror images of each other (though they likely differ in size). Check out your armpit area, too, because breast tissue may go into there. Look for differences in fullness, whether there’s nipple discharge or a change in shape. “Any way that you discover a change is valid,” Dr. Omofoye said. And don’t hesitate to go to the doctor if you notice something’s off. “If everything's normal, we're happy to give you that good news, but you'll have the peace of mind instead of trying to put things off.”

Aside from that, know that diet and exercise are some of the most important measures you can take.If this whole “exercise and healthy weight” thing sounds like a broken medical record, it’s because it’s the bedrock of any healthy lifestyle. Doctors recommend at least 150 minutes of moderate intensity exercise a week. Think: raising your heart rate like you would on a brisk walk. 

Ok, we get it. Exercise is good. But what about if I’m high risk? 

Then you could be referred for blood testing or genetic testing. See: mutations like those BRCA genes we mentioned earlier. That may increase your risk of developing breast cancer by 50% to 80% in your lifetime, Dr. Omofoye said. If you’re high-risk, know “you have options,” she said. The first: you could screen more frequently, with ultrasound, MRI, and/or mammogram. Another: You can consider talking with a surgeon about a prophylactic mastectomy. 

 What treatment is available if you find breast cancer?

Depending on age and how far the cancer has spread, there are a number of treatment options for breast cancer. These include: 

• Surgery to remove the cancer. 

• Chemotherapy to shrink or kill the cancer cells. 

• Hormone therapy to block the cells from getting hormones that make them grow. 

• Biological or targeted therapy to use the body’s immune system to attack cancer cells. 

• Radiation therapy to kill cancer cells. 

Anything else?

“Breast cancer is a serious disease. But it’s very treatable, especially when found at the earliest stages,” Dr. Omofoye said. “Best-case scenario is when it can be found before it can be felt.” Which means screening is important, even for people who don’t have relatives who’ve had it. “About 75% to 80% of breast cancers are diagnosed in people with no family history whatsoever,” she said.

theSkimm

Breast cancer awareness might seem like something that you can put on your future self’s to-do list. But since it’s the second most common cancer for women, it’s worth getting educated now so that you aren’t surprised later.