Most young women and men lead very busy lives, juggling classes, work, activities and much more. With all they have going on, what do they really need to know about breast cancer?
When young women and men speak out on issues they care about they are heard.
One year, when our advocacy organization made our annual visits to members of Congress to urge them to support research and policies to ensure access to treatment, we were joined by a group of high school students. The students were informed, and they listened and asked intelligent, challenging questions in meetings we had with health policy aides for several members of congress. The students were a fantastic addition to our team.
And last fall, I was asked to speak to a group of college students who wanted to hear about my story and to become more educated about breast cancer. Their interest was also very inspiring for me.
Young women and men like these are the ones who will feel the most impact from policy changes that could affect everything from their risk of getting breast cancer to better screening tools, potential life-saving treatments and reliable access to health care.
Here are some of the things I think are important for young women and men to know about breast cancer.
Taking Charge of Our Health
One of the things I think we all need to know, as soon as we reach young adulthood, is that we are the ones who are in charge of our health. I didn’t truly appreciate this until I was faced with a breast cancer diagnosis at the age of 35.
What happened in my case? Well, one day while I was taking a shower, I noticed a lump in my right breast. Most of the time, breast lumps in young women are benign. But not all the time. Part of me wanted to believe the lump I had found was nothing, but I also knew I needed to get it checked out.
My doctor examined me and said we needed to do some testing to find out more. After several tests including a biopsy, the diagnosis came: I had breast cancer. It was a terrible shock. But eventually there was a bit of good news. Although the cancer was invasive, meaning it had spread outside the ducts in my breast where it had originated, we eventually learned there was no evidence (that could be detected) that it had traveled outside my breast to other parts of my body. I would still need pretty aggressive treatment, but I had a good chance to do well.
I was grateful that I had paid attention to the changes I noticed and had acted by seeing a doctor. And that is my first message from my experience: taking charge of our health starts with being aware of worrisome changes in our bodies and getting them checked out by a doctor.
Understanding Breast Cancer Risk
One of the reasons the breast cancer diagnosis was such a shock for me, besides the fact that I was young, was that there was no history of breast cancer in my family.
It’s pretty easy to get the impression from the media that, most of the time, breast cancer occurs because someone has a genetic mutation they inherited from their parents that increases their risk for breast cancer. But this impression is not accurate. In fact, only 5-10% of breast cancer cases involve inherited mutations.
The rest of the time we don’t really know what’s going on. And even when there is an inherited mutation, that alone isn’t enough to cause breast cancer.
There are other “risk factors.” The biggest risk factor is being female, although men can get breast cancer too. For a woman today, the chance of being diagnosed with breast cancer is 1 in 8 over the course of her lifetime. Other risk factors include being older; having dense breasts (which is normal and very common); and having children later in life or not having children (also very common). When these risk factors are present, a person’s chances of getting breast cancer are somewhat higher than average. But most of these risk factors are things we can’t control.
Another area of risk is the risks we are exposed to from external environmental sources. Environmental risks are not well understood. They also disproportionately affect underserved communities and communities of color. This is an area where more research is badly needed. I wrote about cancer risk and the environment in this post.
Several distinguished panels in recent years have evaluated the evidence regarding the contribution of environmental exposures to cancer risk, and have stressed the need for more research. In particular, we need to understand how the multiple environmental contaminants we are exposed to interact in our bodies and their cumulative impact. We also need better methods for measuring exposures and we need to update–and enforce–regulations governing environmental contaminants.
Making Progress Against Breast Cancer
When I was diagnosed with breast cancer, I was fortunate to have health insurance that enabled me to access quality health care, which I received in a timely manner. Obviously, everyone in our society should have similar access and care when they need it, but unfortunately many do not.
Access to high quality medical care including cancer care varies widely in this country–and it’s not just a matter of having or not having adequate health insurance coverage.
A major 2017 study examined trends and patterns of disparities in cancer mortality over the last 35 years. The study’s findings were striking. When looked at by geographic area, which tends to correspond roughly with socioeonomic status, mortality rates differ substantially. The different outcomes are believed to mostly reflect differences in access to screening, timeliness of follow-up when a problem arises and access to treatment. I discussed that study in this post.
These differences are reflected in a rate of mortality from breast cancer that is a striking 39% higher for African American women than for white women in the United States.
Well over 40,000 women and men are dying from breast cancer each year in the United States. Metastatic breast cancer (MBC) is responsible for nearly all of those deaths. MBC is breast cancer that has spread from the breast to another part of the body, most often the bones, lungs, liver or brain.
To really change this story we need much more research focused specifically on MBC. Research focused on MBC seeks to understand what causes metastasis and how we can intervene to shut down this process even after it has started. Although a true “cure” may not be possible, the goal would be to treat the disease in such a way that patients live for a very long time with good quality of life.
My biggest message is that getting involved does make a difference. When enough of us speak out–even if it’s as simple as an email or Facebook message to a representative in Congress about a policy change or research initiative we’re asking them to support, it does make a difference.
Making real progress and saving lives is certainly achievable, but it is going to take dedicated effort by a great many of us and the involvement of young women and men will be critical in those efforts.
Image Credit: Trung Thanh via Unsplash