World Cancer Day: How common is breast cancer in women under 40; read details

Breast Cancer: As far as global data goes, it's considered that about 10 % of diagnosed cases are in below 40 years of age. In India, however, the proportion of cases seems to be higher, 15% to 25% in different published texts.

World Cancer Day: How common is breast cancer in women under 40; read details RBA

Breast cancer is a heterogeneous disease, and this is becoming evident day by day as we are more precisely delving into molecular characterization. It's a disease whose response to treatment &outcome is decided at the molecular level. Breast cancer is usually diagnosed in women over age 40. But it's not unusual to be diagnosed in women aged 40 years or below.

As far as global data goes, it's considered that about 10 % of diagnosed cases are in below 40 years of age. In India, however, the proportion of cases seems to be higher, at 15% to 25%, in different published texts.

World Cancer Day: How common is breast cancer in women under 40; read details RBA

HOW DOES IT COMPARE TO CASES IN OLDER WOMEN?

The breast cancer in younger women is usually considered to be of aggressive biology. It usually presents at an advanced stage, owing to its biological behaviour. The most common subtype to be diagnosed is a triple-negative variety of breast cancer. The proportion of patients diagnosed with hormone receptor-positive is also fair. The prevalence of typical risk factors for breast cancer is difficult to find in the younger population.

Nevertheless, late age at first childbearing, absence of breastfeeding and increased use of assisted reproductive techniques might be the ones which need a closer look. Some of the preventable causes of increased incidence of smoking and alcohol intake in the young population might be adding to the risk, which needs further evaluation. Family history of breast or ovarian cancer also plays a vital part in young patients with breast cancer.

World Cancer Day: How common is breast cancer in women under 40; read details RBA

Compared to breast cancer in older women or post-menopausal women, pre-menopausal breast cancer is more aggressive, higher grade and more likely to be a triple-negative subtype, and that should be kept in mind while deciding the treatment plan. While the chemotherapy and the surgery parts don't differ much in both older and younger populations, dose-dense chemotherapy can be given in a greater number of pre-menopausal women. Hormone therapy differs much in both populations; the younger population is more likely to require and benefit from ovarian function suppression or ovarian ablation.

Nevertheless, the outcome of treatment is good in the younger population with breast cancer and should be treated with the currently available guidelines to gain the maximum benefit.

-          Dr Sachin sekhar Biswal Consultant Medical Oncology, Manipal Hospital Bhusbaneshwar

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