Under 40? Know Your Risk for Breast Cancer

If you’re a woman under the age of 40, chances are you are in the prime of your career. You may also be busy pursuing a higher education, raising a family or juggling the needs of aging parents. In other words, you’re busy, you’re young and one of the last things you may be thinking about is your risk of getting breast cancer. However, nearly 10 percent of all new breast cancer cases are diagnosed in women under the age of 40.

It’s a sobering statistic, especially because breast cancer in younger women is often more aggressive than breast cancer in older women, according to the American Cancer Society. In addition, experts at Miami Cancer Institute, part of Baptist Health South Florida, believe the numbers may be even higher in the region.

Starr Mautner, M.D., breast surgeon at Miami Cancer Institute.

The good news is that at Miami Cancer Institute, physicians are tracking and studying young patients closely to determine local case numbers, as well as to develop strategies to prevent breast cancer in this age group. They also are playing a key role in researching new treatments for younger women and offering cancer survivor programs specific to their wishes.

They want young women to know these 10 things about breast cancer:

1. Get a breast cancer risk assessment sooner rather than later. “By age 30, every woman should have a conversation with her primary care physician, ob/gyn or internist about her risk for breast cancer,” said Miami Cancer Institute breast radiologist Kate Lampen-Sachar, M.D. “This assessment is very important.” Found early enough, most breast cancers are curable.
2. Breast self-exams are critical. Because a woman at average risk for breast cancer doesn’t usually begin mammogram screenings until age 40, monthly self-exams should be performed. According to the Journal of Clinical Oncology, nearly 80 percent of breast cancers found in young women are discovered during self-exam. Learn how to perform a self-exam, below.
3. Know your family history. If you have relatives with breast cancer or other cancers, ask your doctor about genetic testing and counseling. While a small percentage of cancers are caused by inherited genetic mutations, younger cancer patients test positive for mutations that put them at risk more than older patients. “It’s also important to remember that you inherit 50 percent of your DNA from your mother and 50 percent from your father,” said Starr Mautner, M.D., Miami Cancer Institute breast surgeon. “Your father’s family history is just as important as your mother’s.” Every woman diagnosed with breast cancer should undergo genetic testing, she added.
4. Women of color are disproportionally affected. Black women under age 35 have breast cancer rates twice as high as white women of the same age, and Hispanic women also have a higher incidence. Both groups die from breast cancer more often. Miami Cancer Institute is following subgroups of women to determine if they should begin screening earlier than others or should supplement their annual mammogram with an ultrasound or breast MRI.
5. Not every lump and bump is cancer. Miami Cancer Institute offers the Benign Breast Clinic for those who have non-cancerous conditions as well as the Breast Cancer Prevention Clinic. These programs can provide reassurance for those at low risk and close follow-up and preventative measures for those patients at the highest risk of breast cancer.
6. It’s possible to preserve your fertility if you need cancer treatment. “We talk to all of our young patients about fertility and their plans for the future before they begin treatment,” said Dr. Mautner, who refers interested patients to the onco-fertility team. Many women will opt to freeze their eggs for future use.
7. Don’t delay seeing a doctor if you are pregnant and/or breastfeeding and feel something unusual. It’s a myth that you can’t safely undergo imaging procedures if you are pregnant and/or breastfeeding. “In pregnant women, we will do a mammogram if it’s absolutely necessary,” Dr. Lampen-Sacher said, “and there is no contraindication for breastfeeding women.” Ultrasound poses no risk and biopsies may be performed safely.
8. You may be eligible for a clinical trial. Whether you are a previvor ― someone with a known risk for cancer but has not been diagnosed with cancer ― or a younger woman with breast cancer, you may be eligible for a clinical trial. Miami Cancer Institute leads and participates in numerous trials. Check here frequently for the latest list of trials.
9. Be proactive. You know your body best. Be your own advocate. Educate yourself about your risk and seek genetic counseling if you have questions. If you suspect something is wrong, don’t delay a trip to the doctor.
10. You are not alone. Because of the rise in breast cancer among younger women, support groups and organizations targeting this age group are now available. Check out the CDC’s Bring Your Brave program as well as the Young Survivor Coalition. Miami Cancer Institute works closely with many local organizations, such as 305 Pink Pack and offers a variety of services through its Survivorship Program and Cancer Patient Support Services.

Breast Self-Exam How To

The breast tissue encompasses the area from the clavicle to the crease below the breast and up high into the armpit. If you’re uncertain about performing a self-exam, ask your primary care physician or gynecologist for help.

• Undress from the waist up. While standing, look in a mirror. With hands on hips and then above your head, look for symmetry. Look for skin irritation or dimpling, a nipple turned inward or swelling.
• Lying down, use your fingertips to feel your breast tissue. Use a circular motion and cover the entire breast. Some people find it easy to follow a clock pattern, others move in rows. “Don’t pinch the tissue, instead use the pads of your fingers,” Dr. Mautner advises.
• Repeat, sitting up.
• Some women find breast exam easier in the shower, using soap or gel.
• Bring any changes to the attention of your doctor.

“Self-exams can be lifesaving, but a lot of women are afraid to do it because they aren’t a specialist and don’t think they know what to look for,” Dr. Mautner said. “If you do it every month, you’ll know if something is new.” Dr. Mautner feels so strongly about self-exam that she posts a monthly reminder on her Instagram.