Confronting early-onset breast cancer:A growing concern for women

Confronting early-onset breast cancer: A growing concern for women

October 14, 2024

Healthcaretoday, Dr Teoh Li Ying, Sunway Medical Centre, breast cancer, early-onset breast cancer, young breast cancer, BRCA1, BRCA2, cancer awareness, mammogram, women's health, fight cancer,

Early detection is crucial in fighting early-onset breast cancer. Start monthly self-examinations at 18 and biannual clinical exams at 25 for high-risk individuals.

By Dr Teoh Li Ying,
Consultant Breast Oncoplastic Surgeon,
Sunway Medical Centre, Sunway City

Breast cancer remains one of the most formidable health challenges confronting women globally. According to the World Health Organization (WHO), it is the second most common cancer overall and the most frequently diagnosed cancer among women, affecting over 2.2 million women in Malaysia. While traditionally associated with older women, there is a troubling rise in cases among younger women, highlighting the need for increased awareness and early detection to help ensure a full and healthy life.

Understanding early-onset breast cancer
Early-onset breast cancer, or young breast cancer, typically refers to cases diagnosed in women under the age of 40 and usually starting from 18 years old. This classification is significant because breast cancer in younger women often presents differently than in their older counterparts.
It is usually more aggressive and may be more challenging to treat. The biological characteristics of tumors in young women can differ, often leading to a more rapid progression of the disease with risk of recurrence at a later stage in their life.

One of the most common myths about breast cancer is related to age. People often think that older individuals are prone to breast cancer, while younger people don’t need to worry. While breast cancer is still more common in women over 50, she also finds that there has been a noticeable uptick in cases among younger women both globally and locally. This trend underscores the need for heightened vigilance and proactive measures in this age group.

Risk factors and implications
The risk factors for early-onset breast cancer are diverse. While age and gender are the primary factors, others include family history, genetic mutations like BRCA1 and BRCA2 gene mutations and lifestyle choices such as alcohol consumption and a high-fat diet. Additionally, fertility issues, late pregnancies, never breastfeed, and the use of birth control or hormonal replacement therapy can increase risk. However, it’s important to note that over half of women diagnosed with breast cancer have no identifiable risk factors beyond gender and age, highlighting the importance of regular screening and self-examination.

The implications of an early breast cancer diagnosis are profound. Young women diagnosed with breast cancer often face unique challenges that differ from those of older women. The impact on a young woman’s health, fertility, and overall well-being can be devastating. Many young women are in the prime of their careers, planning families, or raising young children when they receive this diagnosis. The psychological burden is immense, and the treatment can be especially demanding.

The importance of early detection
Early detection is the key to combat early-onset breast cancer. Monthly breast self-examinations should begin at 18 years old, and biannual clinical breast examinations start at 25 years old for high-risk individuals.

Self-examination plays a crucial role in early detection. If any abnormalities are noticed, consult a healthcare professional without delay. Early intervention can significantly impact treatment.

It is crucial to clarify that tumor markers are not used for cancer detection in breast cancer, as the tests provide low sensitivity and specificity. Additionally, ultrasound alone cannot diagnose breast cancer, as it cannot detect microcalcification and serves as a complement to mammograms. Mammograms are considered the gold standard for breast cancer diagnosis. In cases where follow-up is needed, particularly for younger women with denser breast tissue, additional ultrasounds may be recommended for further evaluation and confirmation.

Optimism in early onset breast cancer treatment
Early detection can significantly improve survival rates and treatment outcomes, making it a key factor in managing this disease. Many patients are afraid of treating breast cancer early due to their concerns about the treatment. However, treatment is not always synonymous with chemotherapy and radiotherapy. Early breast cancer can often be treated with surgery alone. Moreover, the survival rate is significantly higher when breast cancer is treated earlier.

A minimally invasive technique for mastectomy known as endoscopic breast surgery is utilized. This method involves small incisions, typically in the armpit or around the nipple, through which an endoscope and surgical instruments are inserted. It offers benefits such as reduced scarring, less pain, shorter hospital stays, and faster recovery. Additionally, it allows for both tumor removal and immediate breast reconstruction, providing notable cosmetic advantages, especially for early-stage patients concerned about the aesthetic impact of traditional surgery.

Do not be afraid of treating breast cancer or undergoing a lumpectomy or mastectomy, a surgery to remove cancerous tissue in part of the breast or to remove the entire breast. It is feasible to reconstruct your breast during or after the surgery, using options such as placing silicone implants or autologous reconstruction, which uses your own skin, fat, or muscle to form a breast.