Breast Cancer's Unique Impacts on Younger Women; It’s (More) Complicated

Breast cancer is more common when you’re older. But it happens to young women, too. When it does, it’s more complicated and affects them differently.

In the WebMD webinar “Diagnosed Under 40: Breast Cancer’s Unique Impacts on Younger Women; It’s (More) Complicated,” Ann H. Partridge, MD, MPH, discussed those treatment and lifestyle challenges.

“When young women are diagnosed with breast cancer, on average, they’re more likely to hear from breast cancer again,” said Partridge, oncologist at the Dana-Farber Cancer Institute and professor at Harvard Medical School.

“Unfortunately, not the majority, but on average, they’re more likely than their older counterparts to die from it. But the good news is that most women will be long-term survivors.”

That tendency of young women with breast cancer to fall off their treatment plans was most surprising for 66% of webinar viewers polled. Their lower quality of life and higher risk of death were most surprising for 17%.

Another poll asked about treatment-related menopausal symptoms in young women survivors of breast cancer. More than 25% were interested in yoga, mindfulness, and acupuncture.

“Are there any new treatments being researched to prevent recurrence for hormone-positive breast cancer?”

“Do I have other options if I don’t want to complete the full 5 years of endocrine therapy because of side effects?”

“Do you recommend any natural therapies?”

There’s a lot of research going on, since this is unfortunately a leading cancer-related cause of death in women. The vast majority of women will have hormone receptor-positive breast cancer. Many experts around the world are working hard to get more information to help.

Recently, researchers have been looking at breast cancer that might be resistant to endocrine therapies. In the last 10 years, new drugs have come on the market that have more than doubled the time that women are living with advanced breast cancer. Very recently, experts have seen these drugs also improve risk of recurrence in people with ER-positive breast cancer.

Data about these new treatments continue to show promise in improving the risk of recurrence. Younger women are more likely to have node positivity or higher-risk disease. This makes them great candidates for new drugs that show improved results.

For endocrine therapy, it’s a good idea to have a conversation with your doctor if you’re unable to tolerate the therapy. If you’re on ovarian suppression with an aromatase inhibitor (which is effective for young, premenopausal people), it may be better to go to ovarian suppression and tamoxifen or tamoxifen alone rather than come off everything completely.

One year of tamoxifen reduces your risk of recurrence by about 10%, 2 years of tamoxifen reduces your risk by about 30%, and 5 years reduces it by about 50%. Because of this, it’s important to get as close to 5 years as you can. Your doctor can help you stay comfortable during treatment and help with any symptoms. This may involve taking short breaks in treatment.

Ultimately, your decision for treatment will depend on your specific risk.

In terms of natural therapies, things like diet (high in nutrients, fruits, and veggies) and exercise are important parts of an overall care plan.

But be careful with natural medications. “I get a little bit concerned because not a lot of things have been tested for interactions with the drugs that we know are helpful for breast cancer,” said Partridge. “You also have to be careful about not adjusting hormones by accident with any kind of natural product.”

While it’s important to be careful with edible or IV natural treatments, you might try natural therapies like reiki, mindfulness , exercise, and acupuncture.

“Does race play a role in the risk for breast cancer under 40?”

Do men get breast cancer before age 40?

Race does play a role in breast cancer. For women under 40, research shows that young Black women are at higher risk than young White women. When young Black women get breast cancer, they’re more likely to get triple-negative breast cancer.

Experts continue to look into this because triple-negative breast cancer has higher risk of recurrence. And because this is more common in young Black people, it’s going to lead to disparities.

Men rarely get breast cancer, especially under the age of 40. Experts see about 2,000 cases per year in the U.S. in contrast to about 250,000 women.

It’s possible for men under 40 to get this disease, but most of them are in their 70s.

Are symptoms of breast cancer different for those under age 40?

For someone under 40 diagnosed with breast cancer, who should be on their care team?

The symptoms of breast cancer in younger versus older people aren’t different.

The big difference is that older women are typically getting screened. Unless you have a high risk, most young women aren’t being screened. This means that many younger people may not find out they have breast cancer unless they actually notice a change in their body.

No matter what stage in life you’re in, a care team is important. It’s ideal to have an oncologist, surgeon, and radiation oncologist. Others can include pathologists, radiologists, and nurses who give you chemotherapy.

Genetic counselors are also important because they can help you figure out what sort of genetic markers you might have related to cancer.

The other big component on your care team is a social worker or a mental health provider. We try to help make sure that all of our young patients know that we have that kind of support for them. And then, of course, the other huge parts of the team are your friends and family.