A Rising Threat in Young Women and the Implications of Early-Onset Breast Cancer - November 2024

Breast cancer remains one of the most formidable health challenges confronting women globally. According to the World Health Organization (WHO), it is the second most common cancer overall and the most frequently diagnosed cancer among women, affecting over 2.2 million women in 2022 and the top cancer among women in Malaysia. While traditionally associated with older women, there is a troubling rise in cases among younger women, highlighting the need for increased awareness and early detection to help ensure a full and healthy life. Dr Teoh Li Ying, Consultant Breast Oncoplastic Surgeon, Sunway Medical Centre, Sunway City In conjunction with Pinktober 2024, Dr Teoh Li Ying, Consultant Breast Oncoplastic Surgeon, Sunway Medical Centre, Sunway City, discusses this critical issue. She shares the factors contributing to the increasing incidence of breast cancer among young women and the importance of raising awareness, promoting early detection, and empowering women to take control of their breast health. Understanding Early-Onset Breast Cancer Dr Teoh explains that early-onset breast cancer, or young breast cancer, typically refers to cases diagnosed in women under the age of 40 and usually starting from 18 years old. This classification is significant because breast cancer in younger women often presents differently than in their older counterparts. “It is usually more aggressive and may be more challenging to treat”, says Dr Teoh. “The biological characteristics of tumours in young women can differ, often leading to a more rapid progression of the disease with risk of recurrence at a later stage in their life.” “One of the most common myths about breast cancer is related to age. People often think that older individuals are prone to breast cancer, while younger people don’t need to worry,” says Dr Teoh. She shares that while breast cancer is still more common in women over 50, she also finds that there has been a noticeable uptick in cases among younger women both globally and locally. This trend underscores the need for heightened vigilance and proactive measures in this age group. Risk Factors and Implications The risk factors for early-onset breast cancer are diverse. While age and gender are the primary factors, others include family history, genetic mutations like BRCA1 and BRCA2 gene mutations and lifestyle choices such as alcohol consumption and a high-fat diet. Additionally, fertility issues, late pregnancies, never breastfeed, and the use of birth control or hormonal replacement therapy can increase risk. “However, it’s important to note that over half of women diagnosed with breast cancer have no identifiable risk factors beyond gender and age, highlighting the importance of regular screening and self-examination”, shares Dr Teoh. The implications of an early breast cancer diagnosis are profound. Young women diagnosed with breast cancer often face unique challenges that differ from those of older women. “The impact on a young woman’s health, fertility, and overall well-being can be devastating”, Dr Teoh explains. “Many young women are in the prime of their careers, planning families, or raising young children when they receive this diagnosis. The psychological burden is immense, and the treatment can be especially demanding.” The Importance of Early Detection Early detection is the key to combat early-onset breast cancer. Dr Teoh strongly advocates starting regular breast cancer screenings at an earlier age. She recommends that monthly breast self-examinations should begin at 18 years old, and biannual clinical breast examinations start at 25 years old for high-risk individuals. Self-examination plays a crucial role in early detection. Dr Teoh advises women to perform self-examinations regularly and be familiar with the normal look and feel of their breasts to detect any changes early. “If any abnormalities are noticed, consulting a healthcare professional without delay is essential. Early intervention can significantly impact treatment”, she says. Dr Teoh dispels the myth that a blood test can detect breast cancer. However, she clarifies that tumour markers are not used for cancer detection in breast cancer, as the tests provide low sensitivity and specificity. Additionally, she notes that ultrasound alone cannot diagnose breast cancer, as it cannot detect microcalcification and serves as a complement to mammograms. She shares,” Mammograms are considered the gold standard for breast cancer diagnosis. In cases where follow-up is needed, particularly for younger women with denser breast tissue, additional ultrasounds may be recommended for further evaluation and confirmation.” Optimism in Early Onset Breast Cancer Treatment “Early detection can significantly improve survival rates and treatment outcomes, making it a key factor in managing this disease,” says Dr Teoh. She shares many patients are afraid of treating breast cancer early due to their concerns about the treatment. However, she advises that treatment is not always synonymous with chemotherapy and radiotherapy. Early breast cancer can often be treated with surgery alone. Moreover, the survival rate is significantly higher when breast cancer is treated earlier. Dr. Teoh utilises a minimally invasive technique for mastectomy known as endoscopic breast surgery. This method involves small incisions, typically in the armpit or around the nipple, through which an endoscope and surgical instruments are inserted. It offers benefits such as reduced scarring, less pain, shorter hospital stays, and faster recovery. Additionally, it allows for both tumour removal and immediate breast reconstruction, providing notable cosmetic advantages, especially for early-stage patients concerned about the aesthetic impact of traditional surgery. Beyond treating breast cancer, Dr Teoh is also an expert in breast reconstruction surgery. She reassures young breast cancer patients, “Do not be afraid of treating breast cancer or undergoing a lumpectomy or mastectomy, a surgery to remove cancerous tissue in part of the breast or to remove the entire breast.” It is feasible to reconstruct your breast during or after the surgery, using options such as placing silicone implants or autologous reconstruction, which uses your own skin, fat, or muscle to form a breast. Empowering Women Through Knowledge and Support Beyond the physical health implications, a breast cancer diagnosis can have a profound emotional impact, especially for young women. “Young women diagnosed with breast cancer often experience anxiety, depression, and a sense of isolation,” Dr Teoh says. “It’s crucial to provide them with the psychological support they need to navigate this challenging time.” Sunway Medical Centre provides various support systems for breast cancer patients, including counselling services, the cancer buddy programme and access to resources for managing the emotional and psychological aspects of their diagnosis. “Our goal is to empower women with the knowledge, resources, and support they need to face their diagnosis with confidence and resilience,” Dr Teoh explains. “We want to ensure that they are physically and psychologically supported through their treatment.” Sunway Cancer Centre at Sunway Medical Centre, Sunway City, the largest private quaternary hospital in Malaysia. It is the first hospital in the country to obtain three major hospital-wide accreditations, including the Australian Council on Healthcare Standards (ACHS) and the Malaysian Society for Quality in Health (MSQH). SMC has earned multiple awards, including being ranked among the top 250 hospitals globally in Newsweek’s World’s Best Hospitals 2024 rankings. It also retained the top spot in Malaysia and secured among the top 75 hospitals in the Oncology categories within APAC. Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner. For more insightful stories and fun recipes, stay tuned to Motherhood Story!

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