Young Women and Breast Cancer
Courage is the price that
life exacts for granting peace.
— Amelia Earhart
Any woman can develop breast
cancer, even in her thirties, twenties and
sometimes even younger. “Young,” for
the purposes of breast cancer, usually refers
to women under the age of 40.
What is the
risk of breast cancer for young women?
The risk of breast cancer for young
women is very low. According to the American
Cancer Society, less than five percent
of the new breast cancer cases diagnosed
from 1998 - 2002 in the United States were
estimated to be in women younger than 40
years of age.
Although younger women are
less likely to develop breast cancer,
women diagnosed at a younger age are more
likely to have a mutation in a certain gene
that increases their risk for breast and
ovarian cancer. For women with one of these
mutated genes, the estimated risk of developing
breast cancer by age 70 is 14 to 87 percent,
and the risk of developing ovarian cancer
is 10 to 68 percent. It is difficult
to say hat the exact risk of breast cancer
is, and it depends on gene factors and
age. See Genetic Testing
and Counseling of this Directory for more
information about genes and breast cancer.
difference of breast cancer in younger
women is that it can be more aggressive than
breast cancer in older women, and may be
less responsive to hormone treatments. Still,
the ultimate outlook is good. More than 80
percent of young women diagnosed with breast
cancer survive at least five years
after the diagnosis.
What special challenges
do young women face?
Diagnosing breast cancer in
younger women can be more difficult because
their breast tissue is denser (has
more gland and connective tissue and
less fat tissue) than the breast tissue
of older women. Mammograms are not
as effective at detecting breast cancer
in women with denser breast tissue.
In those cases, ultrasound may be used
to get another view (or in some cases,
digital mammography or MRI), and biopsies
may be necessary to make a definite
diagnosis as to whether the lump is
benign or cancerous. The vast majority
of breast lumps in younger women are
NOT cancerous. They are most likely
due to fibrocystic breasts or they
are cysts, both of which are benign
(not cancer) conditions.
As a young
woman, if you are concerned about a breast
lump, you may need to be persistent when
working with your doctors to determine
whether a breast lump or other changes
in the breast indicate breast cancer
or a benign condition. Because breast cancer
in young women is rare, physicians may
pay less attention to lumps in young
Younger women are often told a lump
is a cyst or to “wait and see” if
there are any changes.
If you are not completely comfortable
with the information you are given after
a clinical breast examination, mammogram
and consultation with your doctor, do
not hesitate to request further testing
or get a second opinion.
physical experience of having breast cancer
as a young woman (diagnosis, surgery, chemotherapy
or radiation) is much the same as it is for
any woman diagnosed with breast cancer. The
treatment options chosen by you and your
doctors depend on the biology, location and
extent of your breast cancer and what you
feel is best for you.
Young women with breast
cancer have special concerns that often
do not apply to older women with breast cancer.
One challenge that young women with breast
cancer face is that there are limited resources
available to address these issues. Some
of the concerns that young women may have
include: preserving fertility during treatment,
selecting birth control after treatment,
getting pregnant after breast cancer, and
raising young children. In addition, a small
percentage of younger women may have received
a diagnosis of breast cancer during a pregnancy.
women may find it difficult to find other
young women who have gone through similar
experiences. Check the Resources at the
end of this section for groups focusing on
the needs of younger women with breast cancer.
Also, see Women
Building Bridges (a peer
support program). In the Bridges
program, North Carolina women who were
diagnosed with breast cancer at all ages
(some in their 20s, 30s and 40s) have volunteered
to talk with other women who have been diagnosed
with breast cancer.
The emotional or social
experience of having breast cancer as a
young woman can present different challenges
for you. There are a number of questions
or issues that you may face on a physical
and emotional level. First, why did I get
breast cancer at such a young age? Is it
safe, or even possible, for me to become
pregnant after treatment for breast cancer?
Will I be able to find a partner who will
love me regardless of the scars left by breast
cancer? How will the treatment affect
my sexuality? Will the treatment put me in
premature menopause? If I find someone
I care about, how and when do I talk
about (or share) what I’ve been through?How
do I tell my young children that I have
PREGNANCY, BREAST CANCER
AND FERTILITY ISSUES
During pregnancy and breastfeeding
there are many changes to a woman’s
breasts, including tenderness, rapid growth
and increased levels of hormones responsible
for milk production. This can make it more
difficult to evaluate a woman’s breast
for lumps. If there is a breast abnormality,
finding it may be delayed because of the
normal changes a woman’s
breast undergoes during her pregnancy.
Delayed detection may result in diagnosis
of breast cancer that is more advanced.
the ages of 32 and 38, breast cancer is
found most often in women who are pregnant
or have just given birth (National Cancer
Institute). However, it is important to remember
that breast cancer diagnosed during pregnancy
is very rare. The National Cancer Institute
estimates that it occurs in one out of
every 3,000 pregnancies (just .03 percent
The methods for screening
and evaluating breast abnormalities during
pregnancy are generally the same as those
used for women who are not pregnant.
certain adjustments are made to protect
the fetus from exposure to the small amount
of radiation from mammograms. Ultrasound
may be used first and followed with a non-surgical
biopsy, such as fine-needle aspiration
biopsy. (See Making
A diagnosis of breast cancer
during pregnancy can be very frightening
and stressful. However, women have successfully
given birth to healthy babies after
treatment for breast cancer during
pregnancy. Treatment options for pregnant
women depend on the stage of the disease
and the age of the fetus. Consult with
your doctor to determine what course
of treatment is best for you in your
For women who have
had breast cancer and wonder whether it
is safe or advisable for them to become
pregnant, this is a decision that should
be considered carefully and in consultation
with a doctor. Many doctors agree that
it is fine for women free of cancer
and not undergoing treatment to become
doctors recommend that a woman should
wait at least two years after breast
cancer treatment before trying to become
pregnant, to rule out a recurrence.
The decision to have a baby may also
be affected by the woman’s
age, breast cancer characteristics
Some women who have been
treated with chemotherapy drugs for breast
cancer may not be able to become
pregnant. Some chemotherapy drugs
can affect the function of the ovaries,
causing infertility and early menopause.
are already the mother of young children
and have breast cancer, it can be difficult
to take care of your children and tell
them what you are going through. See our
Issues section for
information and resources that can help.
resources listed at the end of this section
may help younger women find answers to
complicated questions. We hope they also
provide some comfort through learning that
there are places to turn and others
who have gone through similar experiences
and have faced similar issues.
Younger Women Do?
- Some breast cancer
organizations suggest becoming familiar
with how your breasts look and feel
by performing monthly breast
self-exam (BSE). The best time
to do BSE is after your monthly period
ends, at the same time each month. Ask
your doctor about how to do BSE correctly or see the Resources
at the end of this section.
you notice a lump or any unusual changes
in your breasts, see your healthcare
provider for a clinical breast exam. Remember,
the vast majority of breast lumps are not
- Clinical breast exams are
recommended for all women beginning
at the age of 20 and every three years after that (after age 40,
have them yearly).
are generally not recommended for women
until after age 40.
- If you have a family
history of breast cancer or several
risk factors (See Who’s
at Risk and What Can YouDo?),
ask your doctor if you need to
have mammograms or other screening
- If you need help paying
for mammograms or treatment, see
and Other Assistance.
- If you have been diagnosed
with breast cancer, think about
seeking treatment from one of the three Comprehensive Cancer Centers
in North Carolina
or from another large cancer center. (See our listing of North
Carolina Hospitals and
Cancer Centers). A larger cancer
center, especially comprehensive ones,
will have more experience treating young
breast cancer patients.
Portions of the above section
were adapted from Facts for Life:
Young Women and Breast Cancer,
from the Susan G. Komen Breast
Cancer Foundation, 800.I’M.AWARE
or www.komen.org, and Breast
Cancer and Pregnancy from
the National Cancer Institute,
800.4.CANCER or www.cancer.gov.
American Cancer Society (ACS)
800.ACS.2345 or 866.228.4327 (TTY)
Young survivors can learn
about each other’s
experiences and get support from the Cancer
Survivors Network, 877.333.HOPE or online
This nonprofit organization provides reproductive
information, support and hope to cancer patients
whose medical treatments present the risk
Living Beyond Breast Cancer (LBBC)
610.645.4567 or 888.753.LBBC (5222)
Addresses post-treatment needs of women with
breast cancer through educational programs,
newsletter, and helpline for survivors and
family members. Hosts Young Survivors Group
and programs focused on young women’s
Cancer Information Service
One of the best resources available for cancer
patients, this government organization provides
the toll-free hotline above in English and
Spanish for questions about any type of cancer
or to order free booklets. Has information
on breast cancer and pregnancy.
Pregnant with Cancer Network
800.743.6724 ext. 308
Offers support and hope to women who are
diagnosed with cancer while pregnant. Has
a peer support program to connect with a
woman who has had cancer while pregnant.
Resolve: National Infertility Association
Provides support and information about infertility,
how to select an infertility specialist and
direction to resources in your area.
This national non-profit organization helps
young Jewish women living with breast cancer.
Links young Jewish women diagnosed with breast
cancer with Jewish breast cancer survivors
for peer support and information. Hosts breast
cancer seminars and has transcripts on caring
for children and fertility issues.
Susan G. Komen Breast Cancer Foundation
972.855.1600 or 800.I’M.AWARE (462.9273)
Foundation for breast cancer research, education,
screening and treatment. Offers the free
fact sheet, “Facts for Life: Young
Women and Breast Cancer” and instructions
on how to perform breast self-exam.
Y-ME National Breast Cancer Organization
312.986.8338 or 800.221.2141 (English)
Offers breast cancer education, support and
a 24-hour hotline (English and Spanish).
Sponsors a ShareRing Network for young women
with breast cancer (call toll-free hotline
or see web site to join).
Young Survival Coalition
212.577.6259 or 877.YSC.1011
A nonprofit network of survivors to help
young women with breast cancer. Has information
about breast cancer
in young women, survivor stories, a newsletter,
e-mail list, annual conference, and ResourceLink.
Books and More
Cancer Legacy (DVD, 2004). Focuses
on the role that genetics and family history
plays in four young women affected by breast
cancer. Companion fact sheet on hereditary
breast cancer. Contact Young Survival Coalition,
877.YSC.011 or www.youngsurvival.org.
the Cow: A Young Family’s
Struggle With Breast Cancer, Loss and Rebuilding,
by Chris Donner (2000). Donner writes an
account of his wife’s struggle with
breast cancer and rebuilding his life and
those of his four young children after her
Fear: A Young Woman’s Personal
Account of Surviving Breast Cancer, by Nancy
Mikaelian Madey (2001). Diagnosed with breast
cancer at 35, just five months after giving
birth to her first child, Madey shares the
struggles of her journey.
for Our Future: How Young Women Find Strength,
Hope and Courage While Taking Control of
Breast Cancer, by Beth Murphy
(book and DVD, 2003). A companion book to
the Lifetime documentary, Fighting for Our
Future, which followed members of the Young
Survival Coalition for two years. Includes
suggestions for the newly diagnosed on treatment,
establishing a support network, and handling
breast cancer while pregnant.
Contagious: The Breast Cancer Treatment
Survival Handbook, by Margit Esser Porter
(1997). Porter was diagnosed with breast
cancer at age 34. Includes advice and practical
tips from women who answered a survey on
coping with breast cancer treatments.
I’m Too Young to
Have Breast Cancer!: Regain Control of
Your Life, Career, Family, Sexuality and
Faith, by Beth Hawkins (2004). Explores
the emotional experience of 16 women under
age 40 facing diagnosis, treatment, and
life after breast cancer.
Devil: To Hell With Cancer—And
Back, by Katherine Russell Rich (1999). A
young woman’s personal account, from
insights about relationships to her disease’s
progression to Stage IV status. She begins
meek and fearful and becomes the kind of
cancer patient she respects.
Something and Breast Cancer: Images in
Healing, by Linda Phelan McCoy (1995).
Captures the reality of young women coping
with a diagnosis of breast cancer. Includes
accounts of spiritual and physical adversities
Catalog Never Stops Coming: And Other Lessons
I Learned from Breast Cancer, by Jennie
Nash (2001). Nash, a young breast cancer
survivor, shares every step of her experience
with breast cancer, beginning with the
Why I Wore
Lipstick to my Mastectomy, by
Geralynn Lucas (2004). Lucas, diagnosed with
breast cancer at age 27, writes a candid
and funny book about her experience, including
thoughts about sexuality, beauty, and having
a baby after treatment ended.
Not Alone (video). An intimate conversation
with six women diagnosed with breast cancer
at a young age. Has a companion resource
guide. Contact Young Survival Coalition at
877.YSC.1011 or www.youngsurvival.org.
Includes a “Young Women and Breast
Cancer” section at www.breastcancer.org/cmty_trans_2006_04.html.
Site has information about breast cancer
and pregnancy, breast health guidelines during
pregnancy, pregnancy after breast cancer
and more. Imaginis.com and She She Me also
have a microsite for young women about breast
health and breast cancer, Breast Health 101
for Young Women, www.imaginis.com/shesheme.
A research group providing evidence-based
information about the safety or risk of drugs,
chemicals and disease during pregnancy and
lactation. Includes a section on breast cancer
Myself: Together Again (M:TA)(Raleigh, NC)
Designed to be a visual guide for younger
women who want to see how their bodies will
transform before, during and after mastectomy
and reconstructive procedures. For a booklet,
contact firstname.lastname@example.org. (2006
Komen NC Triangle Grantee)
Nordie’s at Noon
Shares the personal stories of four women
diagnosed with breast cancer at age 30 or
younger. Book by the same name available
through web site. Encourages women to be
proactive about their health.