‘15% breast cancer cases among younger women’

CHENNAI: Around 15% of breast cancer cases reported today are among younger women in India, and many of them are in their 20s, say doctors of private hospitals in the city.

Though there are many awareness campaigns held on early screening during Breast Cancer Awareness Month every October, the diagnosed cases that come to some of the city-based private hospitals are in the advanced stages.

“It’s a fact that the risk of breast cancer is high for women after 40 years. And, even the screening modalities are focused on assessing the risk among women who are 40 and older. So, it’s not surprising to see undiagnosed cases of breast cancer in women in their 20s,” opines Dr Veda Padma Priya, senior consultant of breast oncology, MGM Cancer Institute. “However, the screening facilities are not as effective in younger women because the density of the breast is high when they’re younger.”

It’s easier to assess the lesions when women grow older because the breast density reduces with age. And, the tumour is usually larger in younger women and the cancer is highly aggressive, which is also a huge challenge.

There are several types of breast cancer and some can be aggressive and can spread at a very fast pace, while others can have a minimal impact. However, even younger women can get aggressive cancers.

“Causes can be hereditary in younger women and there is no single causative factor for the same,” adds Dr Veda.

There are several risk factors of breast cancers such as age, genetics, ethnicity, diet, body weight or obesity, hormonal activity, consumption of hormonal pills without the supervision of a doctor, and late pregnancy. Doctors say that aesthetics and pregnancy are major concerns among younger women, because treatment for cancer impacts fertility, and surgery can affect the overall structure of the breast.

“Self-examination of the breast is important and every woman aged 21 and above should know to look for early changes and symptoms of breast cancer. In the case of family history of breast cancer, clinical breast examination and mammograms are recommended after the age of 25 itself. This helps in reducing the deaths due to breast cancer,” she avers.

Dr Mukta Mahajan, consultant of breast-interventional radiology at Apollo Proton Cancer Centre, says that a crucial part of prevention is screening but most patients come to the hospital after symptoms have worsened such as finding a lump or a discharge. “We have patients who came to us 6 months after they saw symptoms. Cancer was too advanced to treat it. This leads to high mortality mainly because of late diagnosis,” she opines.

Cancer is curable if patients visit the doctor in the initial stage itself. “They might not even require chemotherapy. There are also patients who do regular screening, and this enables a cure faster, and sans any intensive treatment techniques,” she adds.

However, lack of awareness and access to the screening facilities are challenges that cannot be ignored, especially in the lower economic strata. Dr Naveen, head of oncology, Stanley Medical College and Hospital, says, “Yes, screening is a challenge especially in the lower income strata as they don’t understand the benefits. Women in their 20s are getting breast cancer these days, and the numbers are increasing. Though the disease is more aggressive at that age, there is no specific difference in the symptoms when compared to other age groups.”

He urges the government to come up with more focused awareness programmes and screening camps “that should be conducted at regular intervals to encourage early screening and prevent mortality”

PREVENTION POINTERS

• Self-examine your breast every month. Start at the age of 20 to familiarise yourself so that you can notice changes that may occur over time, including lumps, skin changes, or discharge.
• Starting at 30, women should have an annual clinical breast exam by a doctor or a trained healthcare professional. For those under 40, a combination of tests, including a clinical exam and ultrasound is recommended.
• Yearly visits to the doctor for a tailored breast health screening plan are advisable, which may also include a mammogram and MRI, based on individual risk factors.
• Annual mammogram starting from the age of 40.
• A balanced diet rich in fruits and vegetables, 150 minutes of moderate exercise/week, minimal-to-no alcohol and tobacco consumption play a crucial role in prevention.
• Family history: By age 25 or earlier, a full understanding of family health history should be compiled. Get tested for BRCA1/ BRCA2 (genetic testing) for those with a family history of breast or ovarian cancer.