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Breast Cancer In Younger Women

Breast cancer doesn't confine itself to older women.

In the U.S., more than 200,000 women are diagnosed with the disease each year, and thousands of them are younger than 40, the age when national guidelines suggest women get baseline mammograms.

On The Early Show, survivor Khadijah Carter of Brooklyn, N.Y., told her story. The single mother discovered a lump in her breast late in 2002. She had just turned 28. A sonogram was suspicious, and a biopsy confirmed the worst.

Carter had a mastectomy and reconstructive surgery. She's in remission now and takes the drug tamoxifen to help prevent a recurrence.

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Even she was surprised by her own strength. "Listen to your intuition," she advises women. "If you feel that something is wrong, even if the doctor says it's probably nothing, follow up anyway. …I look at myself, I could have just neglected the lump and I would have probably been dead in a year because it was so aggressive."

Oncologist Dr. Ann Partridge of Boston's Dana-Farber Cancer Institute told The Early Show co-anchor Rene Syler that, while young women do get breast cancer, it's relatively rare.

Still, "Young women should bring to their doctor's attention that a lump is changing, or not going away with the menstrual cycle, or associated with skin changes, or something like that."

Partridge adds, "Unfortunately, there are not great screening strategies for younger women. Mammograms, the conventional strategy, are not very effective in younger women because younger women have much denser breasts than older women, so the density in younger women doesn't allow for a cancer to show up. The most common way a breast cancer is detected by a younger woman is self-exam."

Trouble is, by that time, the tumor could be comparatively large and the cancer advanced: "That is one of the biggest problems with younger women, along with the fact that younger women tend to have a much aggressive disease. It's a double whammy."

Younger African-American women may be at even higher risk, Partridge explains, due to a form of the disease that sometimes affects them. It "may portend a poorer prognosis," she says, "so we try to treat them aggressively."

Asked by Syler if young breast cancer survivors can go on to have children, Farber responded, "That's a very controversial issue, and one of the most important issues for younger women when facing a diagnosis of breast cancer and the treatments which may affect future fertility.

In the cases of young women, the medical community grapples with two questions: First, how will the treatment (particularly chemotherapy) affect their fertility? And second, is it safe to have a pregnancy after breast cancer? Says Partiridge, "We really don't know the true answer to that."

She continues, "So, at this point in time, when women want to have a baby after breast cancer, we caution them to wait at least a few years to get the best breast cancer treatment, as well as to get beyond the point when their cancer is most likely to return. But having a baby is such an important thing for so many women and when you don't know the answer, we often encourage them to go ahead."

Still, when breast cancer is caught early, it can generally be treated successfully: "Most women will do well with their breast cancer," Partridge pointed out.

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