As you grow older, your chance of developing breast cancer increases. In fact, two-thirds of cases occur in women ages 55 and older. Still, younger women can develop the disease. According to Marshall OB/GYN physician Christine Cambridge, MD, “We’re keeping an eye on this. A recent study found that more women under 40 are being diagnosed with advanced breast cancer that has spread throughout the body.”
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A steady upward trend
Using a national database of cancer statistics, researchers looked at 34 years of data on breast cancer cases. They noted a small but significant uptick in the number of women ages 25 to 39 with advanced breast cancer. Between 1976 and 2009, the percentage of such cases increased gradually from 4.4 percent to 7.2 percent.
Why the upward trend? Researchers aren’t exactly sure. Dr. Cambridge said, “A number of causes are likely. For instance younger women may be dismissing early signs of the disease because they don’t think it can happen to them. The disease in younger women tends to have more aggressive behavior, and this is a difficult clinical situation that requires more research.”
Vigilance at every age
Mammograms remain the main line of defense against breast cancer. Recent controversy over how early and how often women should receive mammograms has perhaps clouded the public’s perception of its value. While experts, including the American Cancer Society (ACS), don’t recommend mammograms for women younger than age 40, Dr. Cambridge suggests that breast self awareness as well as physician exams are critical in breast health.
“Also, if a woman has factors that increase the risks of breast cancer, earlier, more frequent or enhanced imaging may be in order,” she said.
Physicians of other specialties also tout the importance of mammograms. Said Anietie Okon, MD, a radiologist at Marshall Hospital, “There has been some concern about over-diagnosing women with noninvasive breast cancers and causing anxiety when women are called back for additional testing or biopsy. But for those of us in the trenches, we find that women want to know, and they need to know.”
Dr. Okon said that while mammography is not perfect, it has had a tremendous positive impact on women’s lives.
“Prior to starting mammography screening in the mid 1980s, the death rate from breast cancer had remained static for about 50 years, and it has remarkably fallen by 30 percent since 1990 following the launch of screening mammography,” Okon said. “As a radiologist, I can’t overstate how important it has been. For women 40 and over, we still recommend an annual mammogram, which is in keeping with the American Cancer Society recommendation.”
Research has shown that women who have mammograms are less likely to die from the disease. That’s the big benefit of early detection. And it may well outweigh any potential harm.
The bottom line: Women shouldn’t dismiss having a mammogram. They should talk with their doctor about their individual needs and personal risk factors for breast cancer. Women can then make the best decision for themselves about when and how often to have a mammogram.
The role of breast exams
If you are younger than age 40 and have no risk factors suggesting earlier mammograms, you can still be vigilant about your breast health. Starting at age 20, have a regular clinical breast exam (CBE). The ACS recommends one every three years. “During a CBE, we examine your breasts and your armpits for any lumps or other unusual changes,” Cambridge said. “Being familiar with your own breasts is important, too. Knowing how they normally look and feel can help you quickly notice a change-no matter how small it may be. Remember, breast cancer is often found by a woman herself.”
Not all lumps or other changes mean you have breast cancer. It’s also not uncommon for normal breast tissue to occasionally feel lumpy. But talk with your doctor right away if you notice any of the following:
• A lump or swelling on a breast or under an arm
• A breast that has changed size or shape
• Fluid coming from a nipple
• A change in the shape of a nipple, such as being turned inward
• Red, scaly, or dimpled skin on a breast or nipple.
Dr. Cambridge added, “Women need to know what’s normal for them. Know your body. Then when something just isn’t right, take action. And don’t let finances be a barrier. Marshall has programs to help women who can’t afford a mammogram get one.”
Marshall OB/GYN has services in Placerville, Cameron Park and El Dorado Hills. For more information, visit marshallmedical.org/OBGYN.