Young women finding breast cancer not so rare

By Jamie Durant
Morning News Health/Environmental Reporter
Published: August 20, 2008

FLORENCE — Young women everywhere got a wake up call this month when actress Christina Applegate, 36, announced her diagnosis of breast cancer.

Although breast cancer is typically found in women older than 40, it is not as rare as people think to find it in a women still in her 30s, one local doctor said.

Dr. Jay Pearson, cancer liaison physician for McLeod Health and a general surgeon with Pee Dee Surgical Group, said roughly one in 20 women who have breast cancer are younger than age 40. While breast cancer treatment is basically the same for women of all ages, the emotional toll can be much worse for younger women.

“When it occurs in that age group, it’s usually a shock to the patient and the news itself is more devastating than it is in the older women,” Pearson said. “It’s mostly because these are women with young children and their first concern is ‘What’s going to happen to my child?’”

He said although some of the patients might worry about losing their breasts at such a young age, for the most part, the women are at peace with the idea.

“Some of them are worried about losing their breasts but more of them are very concerned about getting the disease cured and being there for their families,” he said.

And that concern leads to a phenomenon that has been observed in the United States for a few years now: an increase in the number of voluntary bilateral mastectomies, a procedure in which the patient elects to have both breasts removed to eliminate future risk and provide peace of mind. Sometimes these patients have a strong family history of breast cancer. Sometimes the cancer is confined to one breast. Sometimes the patient has undergone breast cancer treatment successfully. Sometimes it’s a combination of factors. For example, Applegate announced in an Associated Press article Tuesday that she had a bilateral mastectomy though both her breasts were cancer-free after treatments. Discovering she had a genetic predisposition for breast and ovarian cancer played a major role in her decision, she said.

Jennifer Howle was just 33 when she began having pains under her arm. The local woman and mother of three boys thought it was just something related to her undergarments, but after a routine doctor visit she found out it was a lump causing the discomfort.

“It was outside the area of my self breast exam, almost on my ribs,” she said. “The pain kept nagging me and nagging me, which was unusual because they say breast cancer doesn’t hurt. That was a gift from God that it was hurting because it kept me on it.”

She said getting a mammogram of the area was difficult since it was near her rib cage, but somehow the technician managed. Since the mammogram showed the lump to be suspicious, Howle’s doctor requested a biopsy which proved the lump to be cancer.

“They did my biopsy on a Tuesday, and on Wednesday when I got home, my mama had taken a phone call that Dr. Tatum wanted to talk to me and it was him on the phone, so she was fit to be tied,” Howle said.

She said she and her husband went to see her doctor together later that day and were told she had cancer.

“I knew my next step was going to be to decide what to do about it, whether to have a lumpectomy, a mastectomy or what I was going to do,” she said. “I just prayed ‘Lord, show me what to do.’”

That’s when Howle and her doctors made the decision to go ahead and have a bilateral mastectomy performed. She was happy with that decision, since she has three small children to care for.

“I just said, ‘Go on and take them both,’ because I figured at my age, there was a good chance it was going to recur,” she said. “That was OK with me. All that was superficial to me. I’ve got my life and my children — as long as I was healthy to take care of them, that’s all that mattered.”

Howle was able to have reconstructive surgery after the procedure to reconstruct her breasts.

“I did have bilateral reconstruction, and trust me, I have much better results than I had before after breastfeeding three children,” she joked.

But Pearson said the drastic route is not necessarily a sure preventative in every case.

“More and more women are coming to the surgeon once they’ve been diagnosed with breast cancer and saying, ‘I want both my breasts removed,’” he said.

The decision is often a psychological one without any medical basis; once mastectomy has been performed and cancer treated, if it’s going to come back, it will come back in the bones or lungs, Pearson said.

Maureen Byrd, cancer nurse navigator and McLeod Breast Health specialist, said a mammogram can be recommended for women as young as 27. She said that typically when breast cancer is found in a younger woman, it is found either by the patient or her doctor during a routine check-up.

Byrd said her role at the hospital is to offer information and support to newly diagnosed women to help them cope with the influx of information coming at them during such a troubling time.

“We also evaluate every breast cancer case in our multi-disciplinary breast cancer conference so each woman’s care and treatment plan is individualized,” she said. “With my breast cancer patients, I’m on call to them 24 hours a day. If they have a concern or problem, I’m just a phone call away.”

For more information on McLeod’s Breast Health Center, visit http://www.mcleodhealth.org/MRMC/womensservices_breasthealth.cfm.