Breast Cancer: What's a Young Woman to Do?

Women in their 20s and 30s are typically concentrating on continuing their education, launching and growing their careers, building relationships, getting to know who they are and perhaps, starting families. Some young women have another subject on their minds: breast cancer.

During October’s Breast Cancer Awareness Month and throughout the rest of the year, Baptist Health Miami Cancer Institute wants to bring attention to breast cancer in younger women. Since 2012, the incidence of breast cancer has risen 1 percent annually. Among women under age 50, the rate has increased 1.4 percent a year and is even higher in certain groups, such as Asian American/Pacific Islander women.

The recommended age to begin regular screening mammograms — for those at average risk of breast cancer — is 40. So what can a younger woman do to prevent or detect breast cancer at an early stage when it is most curable?

Cristina Lopez-Penalver, M.D., breast surgical oncologist at Baptist Health Miami Cancer Institute

It may seem like common sense, but doctors recommend a healthy lifestyle. “That means eating healthy, if you are overweight pursuing healthy methods of weight loss, exercising at least five days a week, avoiding alcohol and not smoking or vaping,” says Cristina Lopez-Penalver, M.D., a breast surgical oncologist with Miami Cancer Institute.

Performing monthly breast self-exams so that you are familiar with your breasts and will note any changes is also important. Starr Mautner, M.D., a breast surgeon at Miami Cancer Institute, puts a monthly “Feel It on the First” reminder on her Instagram. There are many reputable online resources available for those who want more information.

Starr Mautner, M.D., breast surgeon at Baptist Health Miami Cancer Institute

Knowing your family history can be helpful. You should gather your family history of cancer from both your mother and father. Genetic mutations shown to increase breast cancer risk include ATM, BARD1, BRCA1, BRCA2, CHEK2, PALB2, RAD51C, RAD51D, CDH1, TP53, NF1 and STK11. These mutations do not only affect women. More is being learned about genetic mutations and a consultation with a genetic counselor may be in order. Ask your gynecologist or primary care physician.

If you have close relatives with breast cancer, breast cancer diagnosed in theirs 20s or 30s, breast cancer of both breasts, men with breast cancer, or a family history of ovarian, prostate or pancreatic cancer, a referral for genetic counseling and testing is in order. If your testing shows that you have inherited a gene that increases your risk for developing breast cancer, there are measures to take that can prevent or detect cancer early. You can be monitored within a high-risk surveillance program where you will undergo screening twice a year, have a breast exam twice a year and be referred to the surgical team to discuss preventive mastectomies and reconstructive options.

Other risk factors to discuss with your physician include:

·      Early age at first menstruation

·      Over the age of 30 at the time of birth of a first child

·      Race/ethnicity

·      Being overweight

·      Breast density

·      A biopsy that shows atypical ductal hyperplasia, atypical lobular hyperplasia or classic lobular carcinoma in situ

Gladys Giron, M.D., breast surgical oncologist at Baptist Health Miami Cancer Institute

“Not all breast changes or lumps are cancer,” noted breast surgical oncologist Gladys Giron, M.D. “But you shouldn’t hesitate to see your physician if you notice something different.” Definitely make an appointment if you experience any of the following:

·      A lump that you feel or see in your breast or under the armpit

·      Skin changes on the breast, such as dimpling, thickening or redness

·      Spontaneous and unilateral nipple discharge or new inversion

·      Swelling or a change in the size or shape of the breast

“Among the most important things a young woman can do is to know her own body and advocate for herself. Know if something changes and if it’s persisting beyond a couple of weeks, get it checked out. And if you go to your doctor and they say there is something there, but they think it is nothing — that it’s benign — pursue imaging, get a biopsy,” Dr. Mautner says. “My colleagues and I have seen too many cases where a patient was told that it’s likely something benign because they are in their 20s or early 30s, and months later they found out that it actually was cancerous. That can be the difference between life and death.”