Breast Cancer in Young People

Breast cancer in young individuals is not very common. Less than 0.1% of thousands of breast cancer patients diagnosed worldwide are under the age of 20. Due to increased awareness, diagnosis, and registration systems, there is a rise in the rate of breast cancer in young women in less developed countries.

What is Breast Cancer in Young Individuals?

Although younger patients undergo more intensive treatment, delays in diagnosis occur. Due to late diagnosis, young patients present with larger tumor masses and positive lymph nodes. Compared to premenopausal (premenopausal) and menopausal patients, young women have a more aggressive progression with a negative prognosis. Additionally, breast cancer antigens develop that respond less to conventional treatments.

What is the Risk of Breast Cancer in Young Individuals?

The risk of breast cancer in young individuals is lower compared to women over the age of 45. The average risk of developing breast cancer in women in their twenties is 1/1800, and for women in their thirties, it is 1/230. A family history, especially in first-degree relatives with breast cancer at a young age, is the primary risk factor. Considering only age, young women diagnosed with breast cancer are more likely to carry BRCA (breast cancer susceptibility genes) mutations.

What Causes Breast Cancer in Young Individuals?

The causes of breast cancer in young individuals can be as follows: In genetic diseases, the predisposition to breast cancer in young women increases. It is also often observed that breast cancer in young patients occurs spontaneously. No clear relationship has been identified with environmental and familial cancer syndromes. Hormonal and environmental factors have not been definitively explained for the development of breast cancer in young patients. The risk of breast cancer development increases 3-15 years after childbirth. Additionally, unlike older female patients, weight gain and high BMI in young individuals have a protective effect against breast cancer development.

How Are Diagnostic Procedures Conducted in Young Women?

Mammography provides limited data in young women due to high tissue density. In this patient group, ultrasound (USG) and MRI imaging systems provide more information. Breast cancer in young patients may be larger. No clinical trials targeting treatment in young women have been conducted.

How is Breast Cancer Treated in Young Individuals?

Treatment methods in young women are divided into local and systemic approaches.

• Local Treatment:

It involves removing or destroying the cancerous area. Surgical treatment and radiotherapy (radiation therapy) are local treatments. These are used to treat cancer within the breast. Even when cancer spreads to other parts of the body, local treatments may be applied.

• Radiotherapy:

Radiation can complement surgical treatment or be used on its own. The most commonly applied method is external radiation.

• Surgical Treatment:

Surgery is one of the leading treatment methods for breast cancer. Breast-conserving surgery involves removing the cancerous tumor along with some healthy breast tissue around it. After surgery, radiotherapy may be needed to preserve the remaining breast tissue.

Systemic Treatment Methods for Breast Cancer in Young Individuals

Systemic treatment methods for breast cancer in young individuals include chemotherapy, hormonal therapy, and biological therapy using drugs. These methods may be used prior to local treatment to shrink tumors in the breast or to prevent recurrences.

• Chemotherapy:

Chemotherapy involves the use of drugs to eliminate cancer cells. Typically, several drugs are used together for breast cancer. It can be administered orally or intravenously, usually as outpatient treatments conducted every few weeks.

• Hormonal Therapy:

Hormonal therapy aims to stop the activity of hormones necessary for the growth of cancer cells. It is effective throughout the body.

• Tamoxifen:

Tamoxifen is one of the most studied drugs among ER modulators. Its effect on very young patients has not been specifically studied. This drug typically stimulates estrogen secretion from premenopausal (premenopausal) ovaries. According to recent EBCTCG meta-analysis results, the effects of 2-5 years of adjuvant tamoxifen therapy are similar across all age groups.