Early-Onset Breast Cancer
Breast cancer usually occurs in women around the age of 50. However, in some women, breast cancer develops around 18-45 years of age, a condition called early-onset breast cancer. According to the Center for Disease Control, 1 in 10 women who are diagnosed with breast cancer is under the age of 45.
Another report from JAMA 2015 notes that 15% of deaths due to breast cancer occur in women whose disease was detected before 45 years of age. Early-onset breast cancers are generally hereditary but are often diagnosed late. Some of these cancers are also very aggressive and difficult to treat.
Genetic Risk Factors for Early Onset Breast Cancer
Since early-onset breast cancer has a strong hereditary influence, genetics plays an important role in its development. Most women diagnosed with early-onset breast cancer have a family member who has or has had breast or ovarian cancer. Having a male member with a history of breast cancer also increases their risk.
Some genes that have shown to increase risk are:
The BRIP1 Gene
The BRCA1 Interacting Protein C-terminal Helicase 1 or BRIP1 gene contains instructions for producing tumor suppressor proteins. Changes in this gene are associated with breast cancer and Fanconi’s Anemia, a type of early childhood cancer syndrome. The BRIP1 gene, along with the BRCA1 gene, helps repair damaged DNA. The damaged parts of the DNA are removed and the remaining structure is restored to health.
The FGFR2 Gene
The Fibroblast Growth Factor 2 or FGFR2 is a gene that produces proteins to regulate fibroblast growth factors. These growth factors participate in cell growth and multiplication. Mutations or changes in the FGFR2 gene have been associated with multiple types of cancers, including breast, lung, and ovarian cancer.
Non-Genetic Factors Influencing Early Onset Breast Cancer Risk
- The incidences of BRCA mutations are higher in the people of Ashkenazi Jewish descent, increasing their risk for early-onset breast cancer.
- African-American women under 35 years of age have twice the risk of developing breast cancer as white women of the same age.
- Having chest radiation done before you turn 30 for conditions like Hodgkin’s Lymphoma or other childhood cancers increases your risk for early-onset breast cancer.
- A history of non-cancerous breast diseases like atypical hyperplasia or lobular carcinoma in situ also increases the risk of early-onset breast cancer.
Recommendations to Lower Risk of Early-Onset Breast Cancer
- Since early-onset breast cancer is usually hereditary, women with a family history of breast or ovarian cancer must undergo routine screening tests.
- Women who are at high risk must perform self-breast examinations every day and opt for clinical examinations when they visit their gynecologist.
- It may be a good idea to talk to your healthcare provider about genetic testing, followed by a visit to a genetic counselor.
Summary
- Though breast cancer is commonly seen in women over 50 years of age, it can occur in women much earlier, between 18-45 years. This is known as early-onset breast cancer.
- Early-onset breast cancer occurs in women with a strong family history of breast or ovarian cancer in their family.
- Multiple genes have been identified to increase a woman’s risk for early-onset breast cancer. Some of these include BRIP1, MAP3K1, and CASC21.
- Some non-genetic factors like race, descent, previous exposure to radiation to the chest, and non-cancerous breast growths can also increase women’s risk for early-onset breast cancer.
- If a woman has a family member with a history of breast or ovarian cancer, it is important to opt for genetic testing, genetic counseling, and regular breast screenings.
References
https://www.cdc.gov/cancer/videos/breast/bringyourbrave/earlyonsetbreastcancer/introduction-riskfactors/introduction-riskfactors-ADTranscript-508.pdf
https://www.hopkinsmedicine.org/breast_center/breast_cancers_other_conditions/family_history_breast_cancer.html
https://www.genecards.org/cgi-bin/carddisp.pl?gene=BRIP1
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109611/
https://pubmed.ncbi.nlm.nih.gov/24780616/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5666331/
https://www.nature.com/articles/srep12773
https://pubmed.ncbi.nlm.nih.gov/30515698/
https://www.nature.com/articles/srep12773
https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html
