Breast cancer in young women can be more aggressive, less detectable

Advocacy, education shifting to help women who are 40 and under.

Despite the oft-repeated notion that young women don’t get breast cancer, the reality proves otherwise. While it’s true that incidence rates of invasive breast cancer in young women under 50 have remained stable since 1986 and that breast cancer incidence and death rates generally increase with age, the incidence of in situ (contained) breast cancer has continued to increase in younger women since 1999, according to American Cancer Society Surveillance Research.

“While there’s a smaller number of young women getting breast cancer compared to older women, it’s often more aggressive, can be more difficult to detect on imaging, and may be detected at a later stage,” said Amy McKenna, breast cancer coordinator at Miami Valley Hospital who leads a monthly support group for young women at the hospital.

According to the National Cancer Institute, one in 14 women with breast cancer is under age 40 when diagnosed and one in eight women diagnosed with breast cancer is younger than 45 when diagnosed. Breast cancer now accounts for 26 percent of all cancer in women 15-39 years of age and 39 percent of all cancer in 35-39 year-olds.

“As we make more progress in understanding and treating breast cancer in women over menopause through screening and hormonal therapies, increasing attention is being paid to younger women,” said Dr. Susan Love, a leading breast cancer researcher based in Santa Monica, Calif. “We need to figure out the cause of breast cancer in this population and we need new approaches to determine who is at risk at this age.”

Grass-roots organizations like the global Young Survival Coalition and the recently formed Pink Girls of Dayton, Ohio, are drawing attention to the unique needs of women under 40 who have been diagnosed with the disease. These women in their 20s and 30s often face issues ranging from dating and body image to fertility and early onset menopause.

Dana Griffin, communications manager of New York based Young Survival Coalition, said as the public is becoming more aware that young women can and do get breast cancer, more women are seeking medical treatment.

“But many young women get diagnosed at a later stage because they are still unaware they can get breast cancer, and sometimes even their medical professionals are unaware. By the time they come back to their health care provider six months or a year later to have a concern rechecked, the cancer may have advanced to a later stage.”

According to the American Cancer Society, the five-year relative survival rate is lower among women diagnosed with breast cancer before age 40 (83 percent) compared to women diagnosed at ages 40 or older (90 percent). This may be due, according to the ACS, to tumors diagnosed at younger ages being more aggressive and less responsive to treatment.

Love, the author of “Dr. Susan Love’s Breast Book,” said that while postmenopausal breast cancer is concentrated in Western countries, the incidence of breast cancer in younger women is similar through out the world.  

“This is coming to be understood as we recognize that the biology of the disease is different in younger women of all races,” she said, adding that new research by Dr. Pepper Schedin of the University of Colorado suggests that breast cancer is more common during pregnancy and lactation and for the next five years after giving birth. After that, she said, having been pregnant reduces the risk. 

“This may be due to the growth factors, hormones and stimulation necessary to convert the breast into a ‘milk factory’ and then back to a resting breast,” Love explained. Her research group, The Love/Avon Army of Women, is particularly interested in a youthful population in which the classical risk factors appear to be less important.  

“We need women with breast cancer and women who have not developed it if we are going to figure it out,” said Love, who is hoping that women in the Miami Valley and across the nation will sign up for in a study at the Washington University School of Medicine in St. Louis, which is looking at what genetic factors may play a role in the development of breast cancer in young women.
Breast cancer survivor Heather Salazar is the founder of the Pink Ribbon Girls of Dayton. The Tipp City mother of four is determined to give other young women the kind of support her friends and neighbors provided when she was diagnosed.

Her organization, which has its roots in Cincinnati, is going after grants that will help deliver home-delivered meals, housecleaning and child care to young women going through treatment. Volunteers will also visit middle schools and high schools to educate young women about breast cancer.

“How are you supposed to fight this disease when you still have to get your kids to sporting events, do the laundry and make dinner,” Salazar said. “We all have the same goal — to be able to grow old and move forward in life.”

Photographed in the nude for the recent SCAR exhibit that traveled to Cincinnati, Salazar is also an active member of the Young Survival Coalition’s online support group.

“In the month of May we lost six women to breast cancer in the Young Survival Coalition,” she said. “They left nine children without their mommies.”

That scenario is very real to Salazar who, after having three children of her own, cared for and adopted a baby whose mother died of breast cancer at age 24. Then, in 2005, Salazar discovered a lump in her breast that proved to be malignant. She was treated with a bilateral mastectomy, chemotherapy and Herceptin, one of the newest cancer drugs.

“The first treatment my mom took me to, they asked her for her wrist to put the medical bracelet on,” Salazar said. “They thought she was the patient.” 

“If cancer is a gift, I might return it,” Salazar says now. “It has been hard and scary. But I would never return what it has brought me: it has taught me to live genuinely and it has brought me my survivor sisters. I never thought I would see my son play high school basketball and I never take that for granted. I am so grateful to watch them grow up.”

Sabrina Churchill, a sophomore at Miami University’s Middletown campus, is planning two NFL Penny Wars fundraisers Oct. 11 and 18 for breast cancer research. She says the cause “hits close to home.”

“My grandmother is a breast cancer survivor and has been cancer-free for 10 years and my mother is waiting for biopsy results to find out if she has breast cancer,” she said.

Christine Prenatt of Springfield says this is definitely not her grandmother’s breast cancer.

“My grandmother was in her 60s when she was diagnosed and passed away,” said Prenatt, who was diagnosed at age 37 and chose to have a bilateral mastectomy. “In those days you didn’t talk about your breasts or any disease involving your breasts. Chemo wasn’t as effective then, and you got violently ill. To go through all that and know you had a death sentence and couldn’t talk about it must have been horrible!”

The mother of a 10-year-old and 7-year-old, Prenatt is grateful that her own generation is able to talk freely about breast cancer and take advantage of newer and more effective therapies. She was captain of a Relay for Life team at Tecumseh High School, walked with the Springfield Regional Center Cancer Team at the Springfield Strides Against Breast Cancer walk Oct. 1 and belongs to the Pink Ribbon Society.

Today, she said, support is there — emotionally, spiritually, financially.

“Talking is always cathartic, especially for women,” Prenatt said. “We like to gab and when we’re hurt or scared we look for those with common experiences to help us cope.”

Contact this reporter at (937) 225-2440 or

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