Young Women and Metastatic Breast Cancer

Woman with cancerLast month I attended and spoke at C4YW, a conference sponsored by Living Beyond Breast Cancer and the Young Survival Coalition. The conference was for women under the age of 45 who have been diagnosed with breast cancer. The two women in this post are based on composites of numerous women at the conference.

“Marsha” is 25 and has never had children. “Erica” is 31 and the mother of two. Both felt something abnormal in their breasts during self-examination. Marsha’s primary-care doctor agreed with Marsha that something wasn’t right and referred her to a breast surgeon. Erica’s ob-gyn said she thought everything was fine, and that there was nothing to worry about. Marsha’s breast surgeon diagnosed her with mastitis, an inflammation of the milk ducts. Marsha thought this was odd because she had never breastfed, but given the fact it was a breast surgeon telling her this, she went along with the diagnosis and took the prescribed course of antibiotics.

Meanwhile, a year went by for Erica. She still felt an abnormality in her breast, reported it to her ob-gyn, and was still told that everything was fine.

Back to Marsha: Her “mastitis” didn’t improve with antibiotics, and the abnormality in her breast was getting bigger. The breast surgeon gave her another course of antibiotics. Again, Marsha’s gut told her that something else was going on, but again, this was a well-respected breast surgeon. Surely he knew what he was treating, right?

In spite of what her ob-gyn told her, Erica decided to visit a breast surgeon. The surgeon found a lump that ended up being breast cancer. Sadly, the cancer had already metastasized, which meant Erica had stage IV breast cancer—treatable but incurable.

After Marsha’s second course of antibiotics, her breast lump started protruding more. She also found herself getting short of breath easily, which was unusual for her. Marsha went to a new breast surgeon. Like Erica, she was found to have stage IV breast cancer, which had already metastasized to her lungs, explaining her shortness of breath.

Marsha and Erica are just two examples of the many young, previously healthy women whose lives are turned upside down and shortened by breast cancer. I share these stories with you because of the continued misinformation that remains regarding young women and breast cancer. Only about 5% of breast cancers are diagnosed in women under 40. So, while it is not commonly found in young women, it does happen.

Breast cancer in young women tends to be more aggressive than in older women. Survival rates are substantially poorer in younger women with stages I and II compared with older women. Young African-American women are more likely to get aggressive forms of breast cancer than anyone else, and those under 35 die from it three times as often as Caucasian women the same age. Women ages 20 to 59 die more frequently from breast cancer than any other cancer, and most women with breast cancer do not have a family history.

Mammography is not a reliable screening tool in young women because of the denseness of their breasts. Therefore, the importance of monthly self-examination cannot be emphasized enough. If something is found during self-exam, get it evaluated without delay. Some reasons women don’t go to the doctor are: I can’t possibly have cancer because I don’t feel sick; the doctor will be upset with me if it isn’t a cancer; I don’t want to take up the doctor’s time; or I just can’t deal with this. Also, as noted above, a medical provider may not always be thinking about breast cancer in a young woman. The take-home message from this post is this: Trust your gut instinct. If you feel that something is not right, get a second or even third opinion.

In my next article, we will discuss the psychosocial issues that are of concern to young women with breast cancer.

“Know that you can always choose your own inner peace—regardless of circumstances.” —Jonathan Lockwood Huie

© Copyright 2013 GoodTherapy.org. All rights reserved. Permission to publish granted by Norma Lee, MA, MD, LMFT, therapist in Bellevue, Washington

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Quint

    Quint

    March 7th, 2013 at 10:06 PM

    Both of those stories are so sad. To know that they could have been diagnosed and treated much earlier and with better outcomes is heart breaking.

  • rhoda

    rhoda

    March 7th, 2013 at 10:09 PM

    watching my mom go thru breast cancer was hard enough i can’t imagine having to watch my daughter go thru it

  • Simone

    Simone

    March 7th, 2013 at 10:34 PM

    Trusting your gut cannot be underestimated in the quest for good health. It can also extend to having a gut feeling about other people in your family. I knew my dad wasn’t acting quite right and so I had him go see his general practitioner. He was then referred to a cancer specialist who found he did indeed have cancer. So, because I listened to my gut and had him go to the doctor (kicking and screaming I might add), he was able to get early treatment and is now cancer free.

  • Lara

    Lara

    March 7th, 2013 at 10:37 PM

    When will doctors start taking young women seriously?

    Not only do women need to trust their instincts (as both did in these scenarios), they also need doctors who will listen to them!!!!

  • beau

    beau

    March 7th, 2013 at 10:38 PM

    Cancer sucks!

  • Kim D

    Kim D

    March 8th, 2013 at 3:50 AM

    I have never really thought of breast cancer being a young woman’s disease up until I read this.
    We don’t do mammograms until women ar 40, so these are women who are missing out on one of the nest diagnostic tools available all because their age does not meet the normal criteria for thos who uisually get the disease.
    I hope that the medical community uses this as a wake up call, that there has to be more screening and detection among our young women too. This will have to go through a process of changing how we all think about breast cancer, but is certainly something to warrant attention.

  • Ashley

    Ashley

    March 8th, 2013 at 9:16 PM

    Breast cancer has touche three generations of women in my family. Before my Mom’s treatment, she allowed me to feel what the ‘lump’ felt like. Women of ALL ages should be educated more on what this looks/feels like. And in celebrating International Women’s Day today, I choose to take responsibility for my mental and physical health!

  • nate

    nate

    March 9th, 2013 at 5:14 AM

    My sister was only 27 when she received her diagnosis. She only lived for a year after, so if you think that this is not for the young, Danielle’s story is that it is.

  • marina

    marina

    March 9th, 2013 at 10:28 PM

    The I-cant-have-it attitude is not a good one to possess.And while commoners can be forgiven for having that attitude,professionals should know better.They ought to follow the better-safe-than-sorry method than to dismiss fears.

  • Mark

    Mark

    March 10th, 2013 at 4:16 AM

    I think that most of us are appalled when we feel like doctors are not listening to what their patients are saying if it doesn’t fit the typical treatment plan. These are young women who are losing their lives because a doctor thinks that this can’t be what is happening to them because they don’t fit that mold, and are doing nothing more than the bare minimum to treat them until it is far too late to help. Their stories may be clear cut examples of what breast cancer tends to look like, but many medical providers seem to keep their blinders on because this is not what they learned that it SHOULD look like because of the age factor.

  • Annie

    Annie

    March 11th, 2013 at 3:01 AM

    Ladies- we know our bodies better than anyone else does, yet we seem to be okay with taking a doctor at his word even when we know deep inside that there is something wrong that they aren’t getting. It is so important to listen to your body, know your self, and if you talk to a doctor when you think that there is somethig wrong but you don’t feel like you are being heard, that is the time to start getting another opinion. It is okay to solicit the advice of another medical professional if you don’t really think that your doctor is hearing what you have to say, taking your concerns seriously, or even getting to the real root of your problem.

  • Kevin

    Kevin

    March 20th, 2013 at 5:52 AM

    Dear Norma:

    Thank you very much for letting your readers know about C4YW and for sharing the both unique yet similar stories of event attendees.

    On behalf of all of us at LBBC and YSC, I would like to extend an invitation to young women affected by breast and their caregivers to join us for C4YW 2014, scheduled to take place February 21-23 in Orlando, FL.

    For additional information, anyone interested in the work being done by C4YW’s event hosts or the conference itself can visit lbbc.org, youngsurvival.org and/or c4yw.org.

    I look forward to reading more of your insights concerning young women and breast cancer in the coming weeks.

    Warmly,

    Kevin Gianotto
    Associate Director, Marketing
    Living Beyond Breast Cancer

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