Breast cancer rates are rising among women under 50. These Canadians share personal stories amid 'out-of-date' screening guidelines
According to research by the University of Ottawa, breast cancer rates are rising in younger women aged 20 to 50.
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A few years ago, when Robyn Goldman was 33, she noticed an odd lump on her left breast she hadn’t had before. Sometimes, she could even see it distort the shirt she was wearing. There was no pain or discharge that might indicate a condition like breast cancer, but still, she was worried. “Something in my gut told me this is something serious,” said Goldman.
Finding medical validation was a hurdle. She saw her doctor several times, who told her she was young and had nothing to worry about; women her age typically had dense breasts and a mammogram would just expose her to unnecessary radiation.
Following different advice from someone at a women’s hospital in Toronto, Goldman went to the ER because she knew they couldn’t turn her away. An ultrasound and eventual biopsy confirmed what Goldman had feared: She had triple-negative breast cancer. “So if I would have waited until that recommended age of 50 for a mammogram, I would be dead by now,” she noted.
Goldman’s experience parallels many experiences of Canadians whose medical concerns and symptoms are dismissed because of their age. However, new data suggests it’s this age group we need to start paying more attention to.
According to research by the University of Ottawa, breast cancer rates are rising among women in their 20s, 30s and 40s. The study, published in the Canadian Association of Radiologists Journal in late April, reviewed breast cancer cases over 35 years to shed light on trends in breast cancer detection in Canada. The school’s press release noted researchers highlight the need for an immediate shift in public health policy as early detection is key to reducing breast cancer death and complications.
Moreover, the Canadian Cancer Society (CCS) is now urging all provinces and territories to begin screening for breast cancer at age 40 for people at average risk of the disease. In a statement on Thursday, the organization noted it’s changing its position due to evolving evidence and the number of younger people frustrated they’re left out of the Canadian Task Force on Preventive Health Care’s guidelines to begin screenings at age 50.
“Over the last several years, there has been a groundswell of support for screening to begin at a younger age and for a more inclusive system — one that empowers people between the ages of 40 and 49, no matter where they live, to access screening without barriers,” Dr. Sandra Krueckl, executive vice president of mission, information and support services at CCS, said in the press release.
“Lowering the starting age is an important step, allowing more breast cancers to be found earlier when treatment is likely to be more successful.”
Yahoo Canada recently spoke to Dr. Jean Seely, who led the study and is The Ottawa Hospital's head of breast imaging, as well as breast cancer patients who were diagnosed at an early age.
Canadian guidelines for breast cancer screening are ‘out of date’: Doctors
According to Health Canada, breast cancer is the second most common cancer in Canada. One in eight women will be diagnosed with breast cancer in their lifetime. Some provinces, like British Columbia, New Brunswick and soon Ontario (starting in the fall), offer mammograms to those aged 40 and above through self-referrals, but other parts of Canada only provide them to people aged 50 and older. Seely, who is also a professor in the University of Ottawa's department of radiology, said almost 17 per cent of women in Canada are diagnosed when women are in their 40s.
“And we are seeing that the penalty they pay for not being diagnosed early is they are much more likely to have a more advanced stage of diagnosis and need more invasive treatments,” she added. “And also pay the price of their lives.” She noted not screening women earlier in their 40s will cost around 400 Canadian lives each year. She shared she hopes women can be screened even before that age.
The University of Ottawa research found the following:
Women in their 20s: There were 3.9 cases per 100,000 people between 1984 and 1988. That's compared to 5.7 cases per 100,000 between 2015 and 2019 for a 45.5 per cent increase.
Women in their 30s: There were 37.7 cases per 100,000 people between 1984 and 1988. This is compared to 42.4 cases per 100,000 between 2015 and 2019 for a 12.5 per cent increase.
Women in their 40s: There were 127.8 cases per 100,000 people between 1984 and 1988. That's compared to 139.4 cases per 100,000 between 2015 and 2019 for a 9.1 per cent increase.
Seely said there needs to be more research as to what's causing an increase in breast cancer rates among younger women. However, the findings certainly correlated with what she and her colleagues have been seeing in their practices.
She recommended doing a risk assessment test for women younger than 40, which can determine their lifetime risk of breast cancer, especially for those who have a family history. She added having more than one first-degree relative, or more than two second-degree relatives who have had it, puts women into a higher risk category.
Long-term impacts for younger women in their ‘prime’
Robby Spring was 35 years old when she asked her doctor for a mammogram and ultrasound because of her strong family history of breast cancer — both her mom and older sister had been diagnosed with the disease. A biopsy confirmed Spring also had cancer.
“Going through it as a family was also stressful,” said Spring. “It was shocking. I was scared. There are fertility implications with having breast cancer and I don’t have kids, but I want to have kids.”
Spring finished chemotherapy in December 2023. While her energy is returning, she's still trying to find her footing. She was put into chemical menopause and will soon start taking medication. She also faces longer-term side effects, having gone through chemotherapy, and she will also be going to adjunct therapy. “As someone who is supposed to be in the prime of their career, those are really hard things to have on your plate,” Spring shared.
Although part of her life was put on hold, Spring has put more time into advocacy work through the Canadian Cancer Society. She shared her story of her family and continues advocating for changes, such as earlier screening in women, along with better follow-ups and screenings after treatment.
Seely encouraged women who have noticed any changes in their breasts — whether it be a new area of thickening or lumps — pursue diagnostic testing. Additionally, she said if there are any changes in the nipple or nipple discharge, specifically if it’s watery or bloody, then that might be a sign of cancer. Lastly, if there is a lump in the armpit, that could indicate that cancer has spread to the armpit. “Those are all warning signs of breast cancer,” she said. “And if we identify breast cancer early, the chances of survival are really good.”
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