Breast cancer can affect young women?
The incidence of breast cancer is directly related to the woman's age, ie, the older the woman, the greater her risk of breast cancer, and the peak around the 80's of age. In general, the risk increases greatly after age 50, and about 80% of cases are diagnosed in this range. However, young women (<40 years) may also be affected by breast cancer, but with a much lower incidence. Only 7% of breast cancers occur under age 40.
Cases recorded at an earlier age range around the age of 20 - but they are extremely rare. The main risk factor for young women to have breast cancer is the presence of a genetic mutation? the main genes being BRCA1, BRCA2, TP53 and CHEK2 gene.
Patients at high risk should initiate breast self-examination (self-examination) associated with a medical examination from the age of 20.
Other Factor related to cancer in this age group is treatment with radiotherapy in the chest region (usually to treat a lymphoma in this region) during childhood / adolescence. This thoracic radiotherapy affects the breast in its development phase and predisposes the appearance of breast cancer generally 10 years after this treatment.
Other factors associated with breast cancer at a young age are: family history of breast cancer and ovarian cancer in first-degree relatives, a history of bilateral breast cancer, and a history of breast cancer in men in the family.
The diagnosis of breast cancer in young women is quite difficult and is a major challenge for the doctor, mainly because this is the stage at which most women are very involved in their careers and reproductive / maternity aspects. In this age group, mammography has limitations, since most patients have dense breasts, which makes it difficult to evaluate them and to identify possible tumors, which may be necessary to complement other tests such as ultrasonography or magnetic resonance imaging.
Most cases is manifested as the presence of palpable nodules or changes in the skin (edema or retractions), which correlates with tumors in later stages. Tumors in young women, in general, are biologically more aggressive, being associated with less chance of cure.
Treatment of the disease at this stage of life may require oncologic surgery, chemotherapy, radiation therapy and hormone therapy which may have negative effects on aesthetic / self-image, fertility and also negative psychological implications
Early diagnosis for risk groups
Patients at high risk should initiate self-examination of the breasts (self-examination) associated with a medical examination after the age of 20 . Imaging should be started, that is, imaging for early diagnosis from the age of 25-30. This definition of age to start the exams depends on the presence or absence of genetic mutation diagnosed in the BRCA 1, BRCA2, TP53 and CHEK2 genes, as well as the age of the relative who had breast cancer at a younger age in the family. In general, medical follow-up should start 10 years before this younger case. For women who have undergone irradiation in the thoracic region these tests should be started 8-10 years after treatment (but not before the age of 25).
We caution that the above mentioned about screening exams applies to the performance of exams in patients who do not have symptoms. Patients with any symptoms should seek medical advice and may request these tests at any age, depending on the patient's history and findings of their clinical examination.
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