More women up to 40 years old are diagnosed with breast cancer at ICESP

A study carried out at ICESP (Cancer Institute of the State of São Paulo), which is located in the capital of São Paulo, indicates an increase in the incidence of breast cancer in women under 40 years of age. In 2020, 21.8% of diagnoses occurred in this age group, against 7.9% in 2009.

Altogether, from January 2009 to December 2020, the institution treated 12,569 patients with breast cancer. Of these, 1,441 were younger than 40 years old at the time of diagnosis.

In the period from 2009 to 2014 alone, 626 of the 6,276 patients (10%) were below 40. In the period from 2015 to 2020, the percentage rises to 13%, with 815 cases among 6,293 patients.

The proportion of deaths under the age of 40 has also increased, from 9.6% between 2009 and 2014 to 12.4% between 2015 and 2020, according to the study, published in the scientific journal Cancer Epidemiology.

The results, according to the researchers, are consistent with what is observed in other countries and raise concern about the need to reconsider prevention strategies for younger women. In Brazil, the Ministry of Health recommends performing a biannual mammogram from the age of 50.

“One of the issues currently debated is what would be the ideal frequency for diagnostic exams in this public”, says Laura Testa, one of the authors of the work.

Clinical oncologist at Oncologia D’Or and head of the Breast Oncology Group at ICESP, she explains that breast cancer in this younger population is faster and more aggressive, so simply transposing the screening measures used for older women may not work. the same results.

Biologist Valéria Marteniuk discovered this at age 35, when she was eight months pregnant. More attentive to her body because of her pregnancy, she noticed a small lump in her left breast and alerted her obstetrician. The doctor said it was probably a sign of milk production, but she decided to investigate and asked for an ultrasound. Between the exam on October 3, 2020 and the surgery on December 8 of the same year, the tumor grew from 1 cm to 4.8 cm.

The obstetrician’s decision to investigate the lump in a young woman’s breast is not always the action taken. Despite the increase in cases, breast cancer in patients under 40 remains rare and professionals sometimes take longer to order tests compared to older women or those with a family history.

“So, in addition to being an aggressive disease that does not have an organized tracking, it can take time between the woman palpating and actually having the diagnosis. Then it becomes a snowball: delayed diagnosis, delay in ordering tests”, says Testa.

In the case of economist Julia Maués, the delay in taking the exams had another reason. She was 25 weeks pregnant and due to the pregnancy it was not possible to investigate whether the newly discovered tumor in the breast had spread to other parts of the body. Doctors in the United States, where she has lived for more than 20 years, recommended starting chemotherapy and leaving the other tests until after the baby was born.

“When they told me, I thought: I’m not even drinking coffee because of the baby and are you going to give me chemotherapy? But it was a safe type of chemotherapy. My son was born healthy, full of hair, while I was completely bald”, he recalls.

The need for chemotherapy also scared Marteniuk. She underwent the tumor removal procedure the same day she had the cesarean, shortly after taking Lana into her arms, and didn’t know what the next steps would be.

“My biggest fear was not the surgery, it was chemotherapy, because, for me, it was a sign that the person was dying. Then I broke down. It was the worst moment. I received the news that I would need treatment a week after delivery. , the same day Lana was hospitalized for jaundice. My husband, I and my mother came home crying in the car.”

The biologist underwent 16 sessions of chemotherapy, 18 of radiotherapy and also treatment with the monoclonal antibody trastuzumab, which induces a reaction in the body to combat tumor cells. Today, she is in remission.

“After my case, I found out that two co-workers also had breast cancer before age 40, and one was my manager,” says the biologist.

Marteniuk even had no genetic predisposition. “Only about 10% of women who have breast cancer have an association with hereditary risk, so we need to look at other risks as well,” explains Testa.

The oncologist says that, with the risk better quantified, it is possible to outline an individual strategy, which may include genetic testing, mammograms or lifestyle changes. “The patient must understand if her risk is usual or above average. For this, she should talk to her family doctor or gynecologist and tell her about her family history, physical exercise and alcohol consumption”, she recommends.

Pink October

“On Pink October, we talk very little about alcohol and there are studies demonstrating the relationship between drinking and increased risk of breast cancer”, says the doctor.

She warns of the worsening of the condition at puberty, when the mammary glands are developing. “We need to think about the impact of alcohol in adolescence on the incidence of cancer. Many patients ask me what they can do for their daughters, to prevent them from getting cancer, and I answer that the ideal is to have the healthiest life possible, including in adolescence.”

Another point that is not usually addressed in the month when the disease is highlighted is that breast cancer also affects men, recalls Maués. “I have friends who suffer a lot from this because the pink in the campaign is associated with the feminine.”

The economist’s scans after Max’s delivery on April 9, 2013, revealed that the cancer was also present in the liver, bones and brain. At first, she thought she would not see her son grow up, but she gained a “bonus life span” and decided to work for the rights of patients with metastatic breast cancer.

She is the creator of “It’s Not Pink” and seeks to give visibility to metastatic patients, include them in research and discussions and raise funds for research aimed at this group.

“For some people, pink indicates that they are loved, cared for. For me, seeing pink balloons brings a party idea and it makes no sense to celebrate. It’s a disease that kills thousands! Anyone who has metastatic breast cancer will die from it and they’re celebrating ?”, criticizes.

She also regrets that treatment for the disease is seen as a battle and death as the loss of the war. “Didn’t those who die fight hard enough? Besides, cancer doesn’t win, it dies with the person. Everyone is doing the best they can considering the goals they have.”