Factors affecting younger women with breast cancer
What are the differences between breast cancer in younger women compared to older women?
The effect of the disease and the treatment, both medically and emotionally is very different on a young woman. The very obvious thing is that young women are much more likely to be premenopausal and many of them may not have completed their families; they have issues related to difficulties with dating and body image, after going through breast cancer surgery in particular, and emotionally they have a harder time adjusting, probably in part to all of the things we just discussed, both at diagnosis and in follow-up.
Are there additional risks for younger women?
The other major issue is if they go through premature menopause, that has implications both emotionally for them and for biologic and reproductive reasons, but also for future health risks. They have a lot longer to live, assuming they survive their breast cancer, which most women will, with the ramifications of their breast cancer treatment. So, for example, a woman who goes through premature menopause at, say, 35, she has a lot longer to live with the oestrogen depletion over time than a woman who goes through it at, say, 50 and the average age of menopause is 51. That may have implications for her bones, because we know that can be associated with bone loss; her heart, because we know that premature menopause may increase the likelihood of cardiovascular problems down the line, as well as potentially cognitive functioning. There is some evidence in other settings that premature menopause is associated with increased risk of Alzheimer’s. Now we haven’t seen that in a breast cancer population in any kind of evidence-based way, but of course we worry about that and I think the critical thing now is to collect more data on that so that we can both understand the risks as well as potentially screen and intervene if a woman is at higher risk.
Where can younger women with breast cancer go to access more information?
There is also already a lot of information available on the web through a lot of advocacy sites as well as education sites. I know ASCO has a nice website, cancer.net, Susan G Komen has a nice website, The Young Survival Coalition and the United States has a nice website, there’s a group called The Young and The Breastless who, I believe, are based in Canada and there are many, many other groups that focus on either unique groups of young women or all women with breast cancer but have subgroups and chat rooms that are focussed on young women. So there’s a lot of support out there on the web and the good news is younger women are more likely to be engaged with the web.
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