Who Gets Breast Cancer and Who Survives?
By Hallie Levine Sklar
Young Women Who Get Breast Cancer Are More Likely to Die
Women who are diagnosed with breast cancer before age 40 have slightly poorer prognoses than older women: Their five-year survival rate is about 82 percent, compared with 85 percent among women ages 40 to 74, according to the American Cancer Society (ACS). Why? "Younger women are more likely to have more aggressive tumors," explains Lisa Carey, M.D., medical director of the University of North Carolina Breast Center.
Younger women also tend to have denser breast tissue, which makes it harder for mammograms to detect tumors. That said, these women usually don't get annual mammograms (the ACS recommends yearly screenings beginning at 40), so cases often aren't caught until the woman herself notices a lump — by which time the cancer is often more advanced. Even then, she's likely to be blown off by her physician. "It's common for a 28-year-old to show her doctor a lump, only to have him say, 'You're too young to have breast cancer,'" warns Lillie Shockney, administrative director of the Johns Hopkins Avon Foundation Breast Center.
While you can't control the age at which breast cancer strikes, you can take steps to up your odds of diagnosing it early, which in turn ups your odds of beating it. For starters, if you have a family history of the disease, begin screening 10 years earlier than the age at which your relative was diagnosed, says Shockney. If possible, go to a facility that offers digital mammography, which has higher detection rates than standard mammography in women under age 50, according to the National Cancer Institute (NCI). If you have a strong family history of the disease — two or more first-degree family members, like your mom or sister, have been diagnosed — ask your doctor about more specific diagnostic tests like BRCA gene testing, which looks for hereditary gene mutations that are linked with breast cancer. And know that even if you don't have breast cancer in your immediate family, you may still be at risk if you have relatives with hormone-driven cancers like prostate or ovarian cancer, which are also linked to BRCA gene mutations.
Regardless of your age or family history, have an annual clinical breast exam and do a monthly self-exam. If you do find a lump, don't panic — about 80 percent of biopsied breast lumps are benign. But do call your ob/gyn right away to discuss further testing. And if he says you're too young to worry, tell him you're too young not to — and find another doctor.