Learn about the Annual Conference for Young Women Affected by Breast Cancer (C4YW).
View Komen educational materials for young women with breast cancer.
Breast cancer is rare in young women. Five percent of all breast cancers diagnosed in the U.S. each year occur in women under 40 [96]. This can make a diagnosis especially shocking and challenging for young women. At a time in life most often reserved for family and career, issues of treatment, recovery and survivorship suddenly take top priority.
Prognosis for young women
Breast cancer treatment in young women is often effective and survival is usually good.
However, breast cancers in women under 40 tend to have a worse prognosis than those in older women. The cancers are more likely to be fast-growing, higher grade and hormone receptor-negative [146]. Each of these factors makes breast cancer more aggressive and more likely to require chemotherapy [146].
Breast cancer treatment for young women
Age and breast cancer treatment
Age itself does not greatly affect breast cancer treatment. Treatment options are based mainly on cancer stage and tumor characteristics, such as hormone receptor status and HER2/neu status.
Age may play a role in the choice of certain treatment options over others though. For example, younger women may choose lumpectomy (also called breast conserving surgery) over mastectomy. And, age may play a role in whether your provider recommends chemotherapy or oophorectomy (removal of the ovaries).
Menopausal status and breast cancer treatment
Menopausal status is important for some breast cancer treatments. For example, aromatase inhibitors are only used to treat postmenopausal breast cancer. Thus, they may be an option for young women who have already entered menopause as a result of treatment, but they are not an option for premenopausal women.
Learn more about factors that affect treatment options.
Treatment options for non-invasive and invasive breast cancers
To learn more about treatment options, visit the pages below:
Breast cancer treatment and fertility
A main concern for young women being treated for breast cancer is loss of fertility. Both chemotherapy and tamoxifen can damage the ovaries, causing irregular periods or stopping periods altogether.
With tamoxifen, regular periods should return after treatment ends. With chemotherapy, it is more likely the loss of periods will be permanent. (Certain chemotherapy combinations are less likely to cause permanent menopause than others.) Women younger than 40 at the time of treatment are more likely than older women to have their periods return after chemotherapy. The risk of permanent menopause slowly increases with age. Certain chemotherapy combinations may lower the chances of permanent menopause.
Even in women whose periods return, treatment can shorten the window of time to have children. Because of the danger of birth defects, women should not become pregnant while taking tamoxifen.
Both tamoxifen and chemotherapy tend to bring on natural menopause three to five years earlier than normal. This further limits time for pregnancy and childbirth.
Preserving fertility during breast cancer treatment
Storing embryos
There are steps you can take before treatment begins to help preserve your childbearing options. Storing embryos before treatment is one option. In this procedure, eggs are collected over a number of menstrual cycles. They are then fertilized and stored at very low temperatures. After treatment, the embryos can be thawed and implanted into the uterus.
This procedure has a good rate of success, but it also has some down sides. Treatment may be delayed while eggs are collected, and a sperm donor is needed to fertilize the eggs before they are stored.
Another method stores unfertilized eggs that can be thawed, fertilized and implanted after treatment. This method is much less successful, however and is mainly used in research studies.
Protecting the ovaries during treatment
Drugs like goserelin (Zoladex) and leuprolide (Lupron) may help protect the ovaries during chemotherapy, making it more likely regular periods return after treatment ends. Chemotherapy attacks fast-growing cells. These include not only cancer cells but also cells in other parts of the body, like the ovaries. Goserelin and leuprolide can shut down the ovaries during chemotherapy, which may protect them from damage.
More studies are needed to know if these drugs truly protect the ovaries and speed a return to regular periods. It is also unclear if these drugs affect prognosis.
Talking with a fertility specialist
If you wish to have a child after treatment, you should speak to a fertility specialist before making treatment decisions and discuss your options.
Insurance and financial assistance for fertility services
Insurance coverage for fertility services varies widely from state to state. Check with your insurance provider to find out which procedures are covered in your policy.
Organizations such as Fertile Hope can provide financial assistance when insurance providers do not cover these services.
Young breast cancer survivors
The prospects are very good for young women with breast cancer. With treatment, most women can expect to live for many years.
Learn more about life as a young survivor.
Learn about our efforts to increase awareness about breast cancer in young women.
Updated 06/27/11
