Breast cancer more deadly for the young
Young women with breast cancer are more likely to die than older females despite substantial advances in their survival rate, according to the nation’s first report focussing on breast cancer in women in their 20s and 30s.
The report, by the Australian Institute of Health and Welfare, found that women aged between 20 and 39 years had significantly lower survival rates for the two most common forms of breast cancer than older women.
It found that, between 2007 and 2011, younger women diagnosed with breast cancer had an 88 per cent chance of surviving for five years, compared with a 90 per cent chance among women aged 40 years or older.
And although the five-survival rate of younger women has improved markedly in the last 25 years – from around 71 per cent to 88 per cent – the gains among older women have been even greater.
While the AIHW report did not seek to explain the difference in survival rates, it nevertheless pointed out that younger women are more likely to be diagnosed with very large breast cancers than older women, and fewer small tumours, suggesting that delays in detection may be a contributing factor.
Routine breast screening it not recommended for women in their 20s and 30s, not least because the more dense nature of breast tissue in younger women increases the chances of false positive or false negative readings.
Instead, the primary method of detection is through self-monitoring, while young women considered to be at high risk due to genetic mutations or a family history of breast cancer have access to publicly-subsidised MRI tests.
But, while breast cancer is more deadly in the young women who get it, the prevalence of the disease is far greater among older women.
The AIHW estimates that breast cancer has been detected in 80 women in their 20s and 715 women in their 30s this year, compared with 14,800 women aged 40 years or older.
And although it has killed 65 young women so far in 2015, this is little more than 2 per cent of overall breast cancer deaths.
Prevalence of the disease among younger women may drop even further following an increase in preventive action, including mastectomies.
This has been spurred by advances in the understanding of genes, particularly the discovery that women with mutations of the BRCA1 or BRCA2 gene are at greatly enhanced risk of developing breast or ovarian cancer.
Public awareness of the issue was given a huge boost in May 2013 when actor Angelina Jolie revealed that she had undergone a double mastectomy after discovering she carried a mutated version of the BRCA1 gene that meant she had an 87 per cent chance of developing breast cancer and a 65 per cent chance of getting ovarian cancer.
The AIHW found that since 2001 and last year, the number of mastectomies performed has jumped seven-fold, from 1 per 100,000 to 7 per 100,000.
The increase has been ever bigger among women in their 30s. Just one in every 100,000 had a mastectomy in 2001-02, but by 2013-14 this had risen to 11 per 100,000 – including a huge boost in the aftermath of Angelina Jolie’s declaration.