Understanding early-onset breast cancer: What young women need to know

KUALA LUMPUR - Breast cancer, while traditionally associated with older women, is rising among younger women, thus highlighting the need for increased awareness and early detection to help ensure a full and healthy life.

According to the World Health Organisation (WHO), breast cancer is the second most common cancer overall and the most frequently diagnosed cancer among women, affecting over 2.2 million women in 2022 and is also the top cancer among women in Malaysia.

In conjunction with Pinktober 2024, Dr Teoh Li Ying, Consultant Breast Oncoplastic Surgeon, Sunway Medical Centre, Sunway City, discusses this critical issue by sharing 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.

She said that early-onset breast cancer, or young breast cancer, typically refers to cases diagnosed in women between the ages of 18 and 40.

It is usually more aggressive and may be more challenging to treat because the biological characteristics of tumours in young women can differ, which often leads to a more rapid progression of the disease with a risk of recurrence at a later stage in their life, she said.

"People often think that older individuals are prone to breast cancer, while younger people don’t need to worry. While breast cancer is still more common in women over 50, there has been a noticeable uptick in cases among younger women both globally and locally, which underscores the need for heightened vigilance and proactive measures in this age group,” she explained.

Dr Teoh noted that the risk factors for early-onset breast cancer are diverse, such as age and gender being primary factors, with others including family history, genetic mutations like BReast CAncer gene 1 (BRCA1) and BReast CAncer gene 2 (BRCA2) mutations and lifestyle choices such as alcohol consumption and a high-fat diet.

She said in addition, fertility issues, late pregnancies, never breastfeeding and the use of birth control or hormonal replacement therapy can increase the risks of breast cancer as well.

"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,” she shared.

She said the implications of an early breast cancer diagnosis are profound, where young women diagnosed with breast cancer often face unique challenges that differ from those of older women.

"Many young women are in the prime of their careers, planning families or raising young children when they receive this diagnosis, which is an immense psychological burden and the treatment can be especially demanding,” she said.

As such, Dr Teoh emphasises the importance of early detection, which is key to combating early-onset breast cancer and she strongly advocates starting regular breast cancer screenings at an earlier age.

She also recommended that monthly breast self-examinations should begin at 18 years of age and biannual clinical breast examinations start at 25 for high-risk individuals, on top of self-examination which plays a crucial role in early detection.

She also advised 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 said while also dispelling the myth that a blood test can detect breast cancer.

She clarified, however, that tumour markers are not used for cancer detection in breast cancer as the tests provide low sensitivity and specificity and additionally, ultrasound alone cannot diagnose breast cancer, as it primarily detects microcalcification and serves as a complement to mammograms.

"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,” she added.

Dr Teoh shared that many patients are afraid of treating breast cancer early due to their concerns about treatment, while also advising that treatment is not always synonymous with chemotherapy or radiotherapy, whereby early breast cancer can often be treated with surgery alone, with survival rate being significantly higher when it is treated early.

Dr Teoh utilises a minimally invasive technique for mastectomy known as endoscopic breast surgery which 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, in addition to allowing 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, reassuring young breast cancer patients to not be afraid of treating breast cancer or undergoing a lumpectomy or mastectomy.

"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,” she said.

Dr Teoh added, that breast cancer diagnosis also leaves a profound emotional impact where they often experience anxiety, depression and a sense of isolation, which calls for the crucial provision of psychological support needed to navigate their life.

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. We want to ensure that they are physically and psychologically supported through their treatment,” Dr Teoh added. - BERNAMA