This week, Bobbi Conner talks with Dr. Courtney Stewart about breast cancer risk and detection in younger women. Dr. Stewart is an Assistant Professor of Radiology and a radiologist specializing in breast imaging at MUSC.
TRANSCRIPT:
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. Most breast cancers occur in older women, but rates have been increasing slowly among women younger than 45 years in all racial and ethnic groups. Doctor Courtney Stewart is here to talk about breast cancer risks and detection in younger women. Doctor Stewart is an Assistant Professor of Radiology, and she's a radiologist specializing in breast imaging at MUSC. Doctor Stewart, bring us up to date about what's going on related to increased incidence of breast cancer in younger women.
Dr. Stewart: So, the American Cancer Society published a report last year showing that there's been an increase in incidence of breast cancer in women under 50. So that rate is rising at about 1.4% a year, compared to 1% a year in older women. This report reflects what we've been seeing in practice. I've been practicing for about 13 years now, and I would say over the past 6 to 7 years, we are seeing more women under 40 come in and be diagnosed with breast cancer. I will point out they still remain the minority.
Conner: Do we know what's causing this increase?
Dr. Stewart: We don't. We have some ideas about possible factors, but the reasons are multifactorial. So, some of it is the obesity epidemic, increased alcohol use, having children later in life. And then there's some form of environmental exposures because we're seeing increased cancers, different cancers in younger people across the board.
Conner: Which younger women might be at increased risk of breast cancer.
Dr. Stewart: Well, we know younger women are at increased risk if they have a family member who had breast cancer before 40, had bilateral breast cancer, if they have a male family member who had breast cancer, if they have any sort of genetic mutation, as well if they've had a history of chest radiation for lymphoma as a child.
Conner: What can be done to screen and monitor young women who are potentially at higher risk of breast cancer?
Dr. Stewart: Well, we recommend that all women now have a risk assessment done by their OB/GYN or their primary care provider at age 25. That will help determine whether they are of increased risk or average risk. And if they are of increased risk, we recommend that they be referred to a high-risk clinic. We can start imaging them earlier, typically start breast MRIs as early as age 25, and then mammograms can be started before age 40, if that's appropriate for that patient. So, something younger women can do is to know what's normal for their breasts, how their breasts feel, and if they think that anything has changed or different, they should go see their doctor and have it evaluated.
Conner: What about screening recommendations for women at average risk of breast cancer.
Dr. Stewart: So, for women of average risk, we recommend starting mammograms at 40 and getting a mammogram every year thereafter. If you have dense breasts, which your mammogram report will tell you, we can recommend doing additional testing with a breast ultrasound.
Conner: Why is it so important to diagnose breast cancer early?
Dr. Stewart: We want to catch breast cancer at an earlier stage because it leads to better outcomes. Women are often able to have less aggressive treatment, including less aggressive breast conservation surgery. This is particularly important for younger women because they tend to have more aggressive cancers that can be harder to detect, so we want to see them as early as possible.
Conner: Doctor Stewart, thanks for talking with us about breast cancer risks.
Dr. Stewart: Thank you for having me.
Conner: From the radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming.
