Younger women are getting breast cancer, but why? Is it that women are being tested earlier and do more breast self-exams? Is it genetic? Is it the environment, or perhaps lifestyle and eating habits?
It’s a trend Allison DiPasquale, MD, a breast surgical oncologist on the medical staff of Methodist Charlton Medical Center, has noticed. She says it’s because of several factors.
Reason #1: Breast cancer in general is more prevalent
It used to be 1 in 12 women were diagnosed with breast cancer, but now Dr. DiPasquale says data shows those numbers to be around 1 in 8 women. So, if you’re out to lunch with 8 women, there is a good chance that one of them has had breast cancer, or will get it.
Reason #2: More advanced screening technology
The technology has improved too. Imaging machines with higher sensitivity, like 3D mammography and magnetic resonance imaging (MRI), means more women are diagnosed who previously would not have been diagnosed, or diagnosed much later.
While a standard mammogram offers a view similar to looking at the outside cover of a transparent book, a 3D mammogram can look inside and show the segments of the breast layer by layer. The extra views are important because overlapping breast tissue can sometimes appear abnormal or hide an abnormality. The three-dimensional images offer increased accuracy, and significantly increase the cancer detection rate for women with especially dense breasts.
For women at higher risk of breast cancer, mammography and MRI done together can increase the rate of detection of breast cancer.
Reason #3: Increased awareness of genetic link to breast cancer
Dr. DiPasquale also adds that the medical community is becoming increasingly aware of the genetic link to breast cancer and family history. For high risk patients with a strong family history of breast cancer, doctors start screening 10 years prior to the age when the youngest first-degree relative was diagnosed. For example, if the mother was diagnosed at age 40, then daughters should start screening at age 30.
An average risk patient is one who does not have a family history of breast cancer or any other risk factors. Risk factors include obesity, lack of exercise, dense breasts, the use of oral contraceptives, infertility treatment, hormone replacement therapy, multiple breast biopsies in the past, or a personal history of ovarian cancer.
What else do we need to know about the genetic link to breast cancer?
Many genes can be linked to breast cancer, but the strongest link is in the BRCA genes. The BRCA gene mutations, BRCA1 and BRCA2, have on average a lifetime risk of developing breast cancer of 60-90%, based on which gene mutation you have. There are other genes with a stronger link to a lifetime risk of breast cancer, like CHEK2 and PALB2, and many other genes with weaker links. It is important to note, however, that less than 10% of breast cancers are genetically linked.
The most common way to test for BRCA 1 and BRCA 2 is to run a blood test that examines a panel of multiple genes. The main point, however, is to discuss with your health care provider any cancer in your family and your doctor will make the decision on which gene panel to test. Even if the gene test result is negative, you may have a strong family link to breast cancer and therefore need to be monitored as a high risk patient.
Lower your risk
With the prevalence of breast cancer on the rise and the younger age of women diagnosed, it is important to continue to get yearly mammograms starting at age 40, or prior to age 40 if you are at high-risk. Dr. DiPasquale also urges to continue self-exams since you know your breasts the best and can detect if here are any areas of concern.
One way women can help reduce their risk of breast cancer is by healthy eating. “Studies show that through diet and exercise, you can lower the insulin levels in your body,” says Dr. DiPasquale. “Lower levels of insulin in turn help protect you against breast cancer.”
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