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Managing a High Risk of Breast Cancer in Your 20s

27 Sep 2019 by Krystal Barter
Managing a High Risk of Breast Cancer in Your 20s

If you are in your 20s the risk of breast and ovarian cancer is very low, even though your lifetime risk is high. This means only a very small number of women will develop breast cancer associated with a familial risk during this decade of life.

Managing Breast Cancer Risk

1. Self-Awareness

You are encouraged to be aware of the normal look and shape of your breasts. Being breast aware does not mean being able to diagnose a breast cancer. It means noticing when a change has occurred and what to do when it does. It is important to do this even though the risk of developing breast cancer is small.

2. Breast Cancer Screening (Imaging)

Your Familial Cancer Clinic or Breast Surgeon will recommend the age to commence breast cancer screening and what type of imaging is best for you. However, below is a general guide of what you can expect. If you do not have a hereditary cancer gene mutation, the risk of breast cancer in your 20s is very similar to that of your peers. For this reason breast cancer imaging, (which means to have a mammogram or Breast MRI), does not usually begin in your 20s and is generally recommended to begin in your 40s when the risk of breast cancer begins to increase.

If you do carry a hereditary gene mutation, the risk of breast cancer begins to increase in your mid to late 20s, so it is reasonable to start breast cancer screening with breast cancer imaging in your mid 20s. Your breast specialist may only order a Breast MRI as this is the preferred imaging test in the 20s. This is because breast density in young women makes it difficult to see changes on mammograms.

3. Risk Reducing Medication and Risk Reducing Surgery

Although the risk of breast cancer is low in a woman’s 20s these are valid options to manage a high risk of breast cancer.

The timing of using risk reducing medication and/or surgery needs to be fitted in around having children. This is because for both risk reducing mediation and surgery there are issues to consider with respect to pregnancy and breast feeding. So, for some women it might mean waiting until after they have finished having children, but for others may mean before having children (especially if there is no immediate plans to have children).

The decision for most women is often based on how they think about their risk, their experiences, personal circumstances, values and beliefs. As there are a variety of factors to take into account and the decision and/or timing for using these strategies can differ between women.

No matter what age you are, if you are thinking about these options, it can be useful to seek more information about your breast cancer risk as a first step. In particular you may wish to ask your Familial Cancer Clinic or Breast Surgeon to estimate your risk of breast cancer over the next 10 years. You may be recommended to meet or speak with other health professionals such as plastic surgeons, a psychologist and other women who have chosen these options. This can help you to have the information and support you need to help you decide how to manage your risk.

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