Should Breast Cancer in Young Women Be Treated Differently?

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Even after Ghecemy Lopez, 32, discovered a lump in her right breast and had a mammogram, she still couldn’t imagine she had cancer. She thought breast cancer struck older women, not someone her age. She got the same impression from the admitting clerk at her mammogram who asked, “Why are you here?” But young women, as Lopez and many other women discover each year, can and do get breast cancer.

“When I heard, ‘You have cancer,’ I immediately thought, ‘This can’t be happening. I’m only 30,’” Lopez says. She postponed a trip home to Veracruz, Mexico, and waited before telling her family. “It’s so hard to tell your parents you have cancer.”

More than 290,000 women will be told they have breast cancer in the U.S. in 2013. While breast cancer in women under 40 is still relatively rare, comprising about 5 percent of all breast cancer cases, it still accounts for more than 13,000 newly diagnosed young women each year.

The challenge in treating and caring for these young patients is a relatively new topic, one that has evolved over the past decade. Later this month, the Young Survival Coalition (YSC) will co-host its 13th annual gathering for young women diagnosed with breast cancer with Living Beyond Breast Cancer. The organization also has created a separate research think tank in Washington, D.C., to bring together oncologists, professionals and advocates to discuss issues specific to this population. The Centers for Disease Control and Prevention’s Advisory Committee on Breast Cancer in Young Women, which was established in 2010, will publish some of its first study findings within the next two years.

Whether the result of this new focus is a publication, a conference or peer-to-peer support, those involved share common goals: focused research and support for young women dealing with age-specific short- and long-term consequences of breast cancer treatment.

According to medical professionals, breast cancers in younger women tend to be more aggressive, less likely to respond to hormonal therapy, more commonly harbor a mutation in the breast cancer susceptibility genes (BRCA1 and BRCA2) and can come with a worse prognosis.

Ethnicity may play a role as well. Both African-American and Hispanic women are more likely to be diagnosed at a later stage and have higher mortality rates than white women. Younger African-American women have a higher percentage of hormone-negative breast cancers, which tends to be more aggressive than hormone-positive. In one of the largest studies of Hispanic families with a history of breast and ovarian cancers, BRCA mutations were discovered in 25 percent of those with Hispanic ethnicity enrolled in the Northern California Breast Cancer Family Registry, a significant increase above the average 5 to 10 percent. In a separate study led by researchers from M.D. Anderson Cancer Center in Houston, 714 breast cancer patients of Mexican origin were surveyed and found that half had received a diagnosis before the age of 50.

While some question whether breast cancer in younger women is a different biological entity, the issue is still being debated.

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