Young Breast Cancer Program: Better Care Coordination for Patients

If you imagine the typical breast cancer patient as a middle-aged or older woman with grown children and a well-established life, you might be in for a shock. Today’s breast cancer patient is increasingly decades younger, finishing college, planning a career, just starting life with a partner or navigating the complex demands of early motherhood. 

The significant rise in breast cancer incidence in women in their 20s, 30s and early 40s — and the group’s special needs — has spurred the development of the Young Breast Cancer Program at Baptist Health Miami Cancer Institute. The initiative, led by Starr Mautner, M.D., Jane Mendez, M.D., and Reshma Mahtani, D.O., streamlines care, getting young patients to specialists quickly and addressing their unique needs. 

Younger Patients, Aggressive Cancers

“I see several women in my clinic each week under the age of 45,” said Dr. Mautner, a breast surgical oncologist with the Institute. “A lot of these patients are coming in with aggressive cancers that they have found themselves because they aren’t of screening age yet. By the time they feel a mass, the cancer can be more advanced than if caught early with a mammogram or other imaging.” 

The statistics tell a compelling story. Approximately 10 percent of all new breast cancer diagnoses occur in women under 45, according to the American Cancer Society. At Miami Cancer Institute, the number is even higher — 13 percent. While deaths from breast cancer have been declining, it is still the second-leading cause of cancer death in women (behind only lung cancer), killing more than 42,000 women a year in the U.S.  

Compassionate, Coordinated Care

“A breast cancer diagnosis at a young age can derail some of life’s most important milestones. Through this program, we are not only providing compassionate, coordinated care, but also creating a database of young patients that captures clinical and genomic information. This will give us the ability to ask and answer important research questions in the future about why breast cancer is increasing in this population and how we can improve outcomes,” said Dr. Mahtani, chief of breast medical oncology at the Institute.  

“It’s important that these patients receive a complete workup quickly,” said Dr. Mendez, breast surgical oncologist and chief international liaison. “They may need to start chemotherapy right away, but first they need referrals for onco-fertility or fertility preservation, genetics, plastic surgery and other services.” 

Just for Younger Patients

Through the Young Breast Cancer Program, intake nurses and nurse navigators are immediately alerted to any patient aged 45 or younger. If the patient wishes to participate in the program, the healthcare team schedules the appropriate appointments so that the burden of making numerous calls and trying to coordinate multiple schedules within a compressed timeframe doesn’t fall on the patient or the surgeon. 

“As a young surgeon and a mom, I can relate to what these women are going through,” Dr. Mautner said. “This project has been a passion of mine for quite a while. In addition to streamlining care, it will help reduce the stress these patients are experiencing. Many times, decisions must be made quickly because treatment should begin sooner rather than later. For example, you have a patient who has not had children yet and they’d like to become mothers. These conversations can be overwhelming. You may be discussing whether they will store their eggs or embryos or look at surrogacy — at the same time they are dealing with a breast cancer diagnosis.” 

For Dr. Mautner, satisfaction comes from seeing a young breast cancer patient go on to live a full life, have children if she wishes, participate in sports and have a robust career. Many of her patients become active in the breast cancer community, leading support groups, fundraising efforts and social media awareness campaigns. 

Knowing Your Risk Factors

As for the increase in breast cancer in younger women, physicians aren’t entirely sure what has driven the change. They suspect, Dr. Mautner says, that it is a convergence of environmental, dietary and lifestyle factors, including alcohol consumption. She often speaks to teens about the importance of exercise, eating right, maintaining a healthy weight and not drinking. 

Every woman should have a conversation with her primary care physician or OB/GYN about her risk factors by age 30. The talk should occur earlier for anyone with a family history, known genetic mutation or other concern that may predispose them to cancer, she said. For women at average risk of breast cancer, the current guidelines by the U.S. Preventive Task Force recommend that screening begin at age 40.

VisitBaptistHealth.net/Mammoto learn more or schedule your breast cancer screening this Breast Cancer Awareness Month.

Reshma Mahtani, D.O., chief of breast medical oncology at Baptist Health Miami Cancer Institute

Starr Mautner,M.D., breast surgical oncologist with Baptist Health Miami Cancer Institute

Jane Mendez, M.D., breast surgical oncologist with Baptist Health Miami Cancer Institute