Breast cancer is rare in young women as only five percent of all breast cancers diagnosed each year in the U.S. occur in women under 40. Because of the rareness of the disease, such a diagnosis can be especially shocking and difficult for young women. At a time in their life most often reserved for family and career, issues of treatment, recovery and survivorship unexpectedly take top priority.

As it is for all women, breast cancer treatment in young women is often very effective and survival is usually good. Overall, however, breast cancers in women under 40 tend to have a poorer prognosis than those in older women. The cancers are more likely to be fast growing and a higher grade, and less likely to have hormone receptors, each of which makes the cancer more aggressive. There is some evidence that chemotherapy is less effective in younger premenopausal patients compared to older premenopausal patients.

Breast tissue in premenopausal women is denser and thus it can be more difficult to locate tumors. It is important for young women to be proactive by doing monthly breast self-exams, seeing their gynecologist on a regular basis for a clinical exam and being tuned in to changes in their body.

One of the main concerns for young women being treated for breast cancer is loss of fertility. Chemotherapy and tamoxifen can each damage the ovaries, causing irregular periods or stopping periods altogether. You might want to discuss with your healthcare professional the option of freezing your eggs prior to chemotherapy treatments thus enabling you to have the option of having children at a later date.

With tamoxifen, regular periods should return after treatment. With chemotherapy, however, the chances are greater that the loss of periods will be permanent. Even so, regular periods will usually return in women under 40, with risk of permanent menopause slowly increasing with age. Certain chemotherapy regimens may be able to lower the chances of permanent menopause.

Ovarian Cancer and Young Women
Ovarian cancer is a disease in which malignant, cancerous cells are found in the ovary. There are different variations and strengths of the tumors that occur in ovarian cancer. However, once a tumor is cancerous, it can spread to other parts of the body. Ovarian cancer is especially hard to detect early because the ovaries are difficult to feel and see, and abnormalities are not always found early. Although early detection is difficult due to a lack of symptoms, it is incredibly helpful and dramatically increases one’s chance of survival. The treatment for ovarian cancer is quite intense and complicated.

Ovarian cancer is much less common than breast cancer, with the average woman’s lifetime risk of developing the disease at 1.8% vs. 13%, respectively. It is the eighth most common cancer in women. The disease is diagnosed in women over the age of 55 approximately 2/3 of the time, and women under the age of 55 roughly 1/3 of the time. However, because of the aggressive nature of the cancer, it is especially important that young women who are at high risk for the disease based upon a genetic predisposition or strong family history of breast and/or ovarian cancer, endure rigorous surveillance every 6 months starting at age 30-35 or 5-10 yrs earlier than the earliest age of first diagnosis in the family, and preferably day 1-10 of the menstrual cycle for premenopausal women. For more information on the surveillance recommendations for screening high risk women for ovarian cancer, click here.

Sources: National Cancer Institute, 2007; Susan G. Komen for the Cure, 2007; American Cancer Society, 2007.