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Breast cancer in young women

What does being a young woman mean?

In relation to treatment, the breast cancer world generally refers to pre-menopausal women as 'young', as the treatment options can be different according to menopausal status.

"My breast cancer diagnosis came out of the blue, it was a real shock. A young woman in her 20s or 30s is not thinking about dying. Breast cancer forced me to examine the issue of my mortality. At the time I would have preferred to be making decisions like 'what movie will I see?' " -- Laura

The most recent statistics about the ages of women diagnosed with breast cancer are from the Australian Institute of Health and Welfare report, Breast Cancer in Australia: an Overview 2012, and relate to 2008 data (it takes some time to collate and analyse the data).

Age group (years) Number of Australian women diagnosed  % of all women diagnosed *
Younger than 20 1 Less than 1
21 to 29 65 Less than 1
30 to 39 705 5.2
40 to 49 2,437 18
50 +  10,359 76.4

* Total number of women diagnosed with breast cancer in 2008 was 13,567. Only 1 woman under the age of 20 was diagnosed with breast cancer in 2008, which is less than one per cent of all diagnoses. 

Many people think that there has been an increase in the numbers of young women diagnosed with breast cancer (possibly due to extensive media coverage of high profile young women with breast cancer over recent years).

However statistics from the Australian Institute of Health and Welfare show that the numbers of women under the age of 40 diagnosed with breast cancer have remained between 11 and 13 per 100,000 women, for the last 27 years*.

Source: Australian Institute of Health and Welfare& National Breast and Ovarian Cancer Centre 2012. Cat. no. CAN 67.

Key issues

Young and pregnant

Although the incidence of breast cancer during pregnancy is rare, it can happen. Treatment options may be different. Radiotherapy is often not recommended due to the risk to the unborn baby, so some women choose to have a mastectomy instead of breast conservation surgery. If chemotherapy is required, some women choose to wait until after the birth of their child, however recent studies have shown that babies of women who undergo chemotherapy while pregnant are at no greater risk of complications compared with other babies. 

Fertility

The impact of chemotherapy and hormone therapy can make it harder to get pregnant after treatment ends. There are a number of factors which contribute to this issue, including a woman’s age, and the type of treatment she has and how it affects her ovaries. There are a number of methods for preserving fertility before starting treatment, which may or may not be applicable to your situation. If you are planning to become pregnant in the future, or even if you haven't given children much thought, it's best to consider some of these options before you start treatment. These include mature egg freezing, embryo freezing, ovarian tissue freezing, medications and using a donor egg.

Ovarian suppression during treatment

Ovarian suppression during chemotherapy for women with hormone receptor negative breast cancer may help protect the ovaries and improve the chances of women remaining fertile. This fertility treatment involves a particular type of drug (GnRHa – Gonadotropin Releasing Hormone analog) such as zoladex or goserelin. This drug blocks the hormones that signal the ovaries to develop and release eggs. The drug causes the ovaries to temporarily shut down. The aim of doing this while a woman is being treated with chemotherapy is to protect the eggs from chemotherapy medicine.

Research has shown that for pre-menopausal women with hormone-receptor negative breast cancer, use of a GnRHa (e.g. zoladex) in combination with chemotherapy may protect fertility. Using a GnRHa while on chemotherapy may also reduce the chance of the cancer returning and improve chance of survival in this group of women.

Ovarian suppression does not delay cancer treatment. It may be costly and the benefits and risks are not yet fully understood. If you are interested in finding out more about options that may be suitable for you, speak to your specialist. There may be ways you can access Zoladex through the PBS.

Fertility-related Choices: A Decision Aid for Younger Women with Early Breast Cancer is a free booklet for young women who have recently been diagnosed with early breast cancer.

This booklet contains information about cancer treatment, how it can affect fertility, and fertility options to consider. There are also some worksheets to help you think about these issues. You can order a print copy, or download it here.

Early menopause

Some chemotherapy and hormonal therapies can reduce the level of oestrogen produced in the ovaries, causing your periods to stop temporarily or can bring about permanent early menopause. This generally depends on your age and the medications you are given, but if you have not yet reached menopause, you should discuss this with your doctor before treatment. Early menopause can bring with it uncomfortable side effects, such as hot flushes or vaginal dryness. Talk to your doctor about ways to manage these side effects.

BCNA’s Menopause and breast cancer booklet explains why some treatments, including chemotherapy and hormone therapies, may cause menopause or mimic menopausal symptoms. The booklet includes plenty of tips for managing symptoms, and was developed in consultation with women with breast cancer and health professionals.
You can download or order a copy from our fact sheets and booklets page or by phoning BCNA on 1800 500 258.

Clinical trials for young women

To see what clinical trials are being run for young women diagnosed with breast cancer, visit the Australian Cancer Trials website.

More information

  • If you have been diagnosed with breast cancer, you can order a copy of My Journey Kit, our free comprehensive resource for newly diagnosed women.
  • Fertility-related Choices: A Decision Aid for Younger Women with Early Breast Cancer provides information on breast cancer and fertility. Download or order a copy from our factsheets and booklets page, or call 1800 500 258 and we will post you a free copy.
  • BCNA’s Menopause and breast cancer booklet aims to help women manage the symptoms of menopause that result from breast cancer treatment. Download a copy from our factsheets and booklets page, or call 1800 500 258 and we will post you a free copy.
  • In The Beacon issue 67 (winter 2014) Associate Professor Jane Turner discusses issues that affect young women with breast cancer, and practical strategies to manage them.
  • Join BCNA's online network to connect and share with other women in a similar situation.
  • The personal stories section includes stories written by young women with breast cancer.
  • The Beacon Issue 41 focuses on issues faced by young women. Download a copy by visiting our Beacon magazine archive page.
  • The report from the 2nd National Conference for Young Women Affected by Breast Cancer discusses issues raised at this conference held in Queensland in September 2010.

Publications

Websites

  • Join BCNA's online network to connect and share with other young women.
  • Young Survival Coalition is an international organisation dedicated to the concerns and issues that are unique to young women with breast cancer and includes a bulletin board for support.
  • Sharsheret is a USA-based organisation of cancer survivors dedicated to addressing the unique challenges facing young Jewish women living with breast cancer.
  • The US-based Hope for two website provides information and support to women diagnosed with breast cancer while pregnant.
  • The US-based Fertile Hope website provides information about fertility risks, parenthood options, and pregnancy after breast cancer

Support groups