Education

More women are getting breast cancer in their 20s, University of Iowa research shows

'I'm too young to have breast cancer'

Brooke McKinnon, 28, a cancer survivor, found it “unsettling” that her age group is getting breast cancer at a faster pace than others. (Vanessa Miller)
Brooke McKinnon, 28, a cancer survivor, found it “unsettling” that her age group is getting breast cancer at a faster pace than others. (Vanessa Miller)

IOWA CITY — A growing percentage of younger women are getting breast cancer — with rates among 20-somethings increasing the fastest, according to new University of Iowa-led research.

Although the overall number of affected women in that age range remains well below other age groups, the rate of 20 to 29-year-olds diagnosed with stage 1 to stage 3 breast cancer increased about 2 percentage points a year during the 15-year study period, according to research published in the September issue of the Journal of the National Cancer Institute Cancer Spectrum.

Breast cancer rates for women in their 30s and 40s also increased from 2000 to 2015, although not as fast, inching up about .3 percentage points a year.

The study looked not only at incidence rates but survival rates and found that, in addition to seeing the largest annual percentage increase, the diagnosed 20-somethings had lower 10-year survival rates than their 30-to-40-year-old peers.

Reasons for the worse outcomes could be multifold and include that younger women often experience diagnosis and care delays — in part because breast-cancer screening is less common among that age group.

Physicians might be less suspicious of malignancy in younger patients — even when they show up in clinic with a breast lump, according to researchers.

Detecting cancerous growth in younger women also can be more challenging due to their dense breast tissue, according to the study’s lead author, UI professor of epidemiology Paul Romitti.

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Romitti said the findings could have important clinical and self-care implications — encouraging increased education and self-checks at a younger age.

“Try to avoid care delays with these women,” Romitti said. “Be aware that because they’re traditionally not screened to make sure that when patients report a lump in their breast, it’s checked.”

‘I’m too young’

Brooke McKinnon of Coralville said she’s glad her physician did, when last December she went in for her annual gynecology appointment. At age 27, the UI graduate and Hawkeye rowing athletic trainer hadn’t yet had a mammogram.

But during her appointment, the doctor felt a lump and — given that McKinnon’s mother not even two years before had been diagnosed with breast cancer — the physician encouraged her to get a full work-up, while trying to calm her nerves.

“She’s like, ‘You know, young women get cysts in their breasts sometimes.’ She said, ‘Don’t get yourself worked up, but let’s just get it checked out,’” McKinnon said.

That guarded reassurance did infiltrate McKinnon’s thinking as she waited four long weeks between that original appointment and when they could get her in for more imaging and tests.

“I kind of convinced myself that I’m too young to have breast cancer and this is not cancer and I’ll be fine,” she recalled.

But ultrasound and biopsy results revealed McKinnon — despite her young age — did have cancer — grade 1B invasive ductal carcinoma. She got the call on a Monday morning and by that afternoon she had an appointment with the breast surgeon.

They mapped out a plan for a lumpectomy and more tests, and just after Christmas she learned her cancer hadn’t spread and therefore was considered stage 1.

“That was the best news you could get,” she said.

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McKinnon still endured chemotherapy and continues to undergo hormone therapy — in that her cancer cells grew in response to estrogen and progesterone.

Being premenopausal complicates treatment for younger patients, especially those such as McKinnon who haven’t had children but want to.

“Having my own kid is very important to me, so I did IVF (in vitro fertilization) before even starting chemotherapy,” she said.

When McKinnon was diagnosed, she was engaged — with a wedding date planned for the coming summer. They managed one embryo from the IVF, and she took a drug to protect her ovaries during her cancer treatment — in hopes she’ll be able to conceive without IVF in the future.

After her follow-up radiation, McKinnon today is cancer free and has a good prognosis — not to mention a wedding still on the books for June.

Learning that her age group is getting breast cancer at a faster clip than others, she said, was “shocking.”

“It’s unsettling,” she said.

‘Be alert’

The UI research — in addition to assessing incidence and survival rates by age range — looked at different types of breast cancers and variations by race and ethnicity.

Survival rates were lower among those who identified as non-Hispanic blacks and Hispanics, compared with non-Hispanic whites and Asian/Pacific Islanders.

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Some of those differences could be tied to variations in access to health care, according to Romitti, who is continuing his research by focusing on Iowa women in hopes of identifying life factors that might contribute to incidence and survival rates.

But based on what this initial research has found, his colleague and co-author at Wake Forest School of Medicine, Alexandra Thomas, stressed physicians should reject assumptions that younger women with lumps in their breasts don’t have cancer.

“We want physicians to be alerted to the rising cancer incidence among this population,” Thomas said.

Comments: (319) 339-3158; vanessa.miller@thegazette.com

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