Breast cancer incidence increases with increasing age. But breast cancer can occur at any age and in young ladies also. About only 5-7% of breast cancer occurs below the age of forty years, but still, it is one of the most common cancers in this population. Breast cancer occurring at a young age is biologically different from those occurring in the elderly and poses some unique challenges. Some factors predisposing or associated with the development of young breast cancer are:
- A history of breast cancer in two or more first-degree relatives. History of previous radiation exposure to the chest due to any cause
- Hereditary syndromes such as Brca 1 and Brca 2
- The previous history of atypical ductal/lobular hyperplasia in breast special characteristics/challenges of young breast cancer tends to be more aggressive. Tends to be high grade.
Metastasis to distant sites is comparatively more than usual hormone receptor. Screening mammograms are usually not advisable in this age group except for high-risk cases. Screening mammogram in early age is difficult to interpret because of the dense breast. If suspected, the mammogram is a better modality- however not routinely recommended.
Treatment options are the same as per stage and tumour characteristics; however, breast conservation surgery may be preferred over modified radical mastectomy. Being usually hormone negative, hormonal therapy like tamoxifen or aromatase inhibitors are seldom used. Important considerations are to be given to fertility preservation in young ladies especially one who is unmarried or who have not completed their family.
Breast cancer treatment, chemotherapy, can cause infertility. Various options of fertility preservation are available e.g. embryo preservation, oocyte preservation etc. These options need to be discussed with the doctor before embarking on to the treatment of breast cancer.
Preventive measures for breast cancer include Regular exercise - at least four hours per week. Avoiding alcohol intake Self-breast examination monthly Maintaining ideal body weight not ignoring any lump in breast or armpit.
(With inputs from Dr Mohit Agarwal, Additional Director & Head of Department, Medical Oncology, Fortis Hospital, Shalimar Bagh).
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