More than 60,000 Brazilian women are diagnosed with breast cancer annually. Although the disease is more likely to develop in women over the age of 50, it is becoming increasingly common for younger women under the age of 35 to be affected.
As a Member of Parliament and a physician, I think this is a warning sign for women, who need to be careful and undergo regular preventive check-ups. It is also a reason why the SUS is reorganizing itself to meet this growing patient demand.
There is no point in talking about preventive measures during the Pink October campaign, that is, once a year, when we know the importance of rapid and humane access to testing in everyday life. When it comes to breast cancer, early diagnosis is essential to recovery and saving lives.
Although screening is offered to women age 40 and over for early detection of breast cancer, it is not offered to women under 40 unless they are known to be at high risk. In the meantime, the shape of the patients changed.
If the incidence of the disease has historically been less than 2% in the <35 age group, research currently indicates a higher percentage of 4% of cases. This phenomenon is observed not only in Brazil, but also in many other developing countries.
Among the aspects associated with lifestyle-related risk factors: fewer children, delayed pregnancy, inadequate nutrition, associated with the impulsiveness of daily life, and a sedentary lifestyle, all of which may influence this change in the appearance of breast tumors in younger women.
Breast cancer is the most common occurrence in women in the world, with an estimated 2.3 million new cases in 2020, accounting for 24.5% of new cancer cases in women.
It is known that it is a very diverse disease, with some subtypes and features, with different aggressiveness and requires individual treatment. It’s common to hear people say that tumors in younger women are always more aggressive, however that’s not the absolute truth.
Although rare, there are slow-growing tumors in young patients and aggressive cases that occur in older women. What happens is that the frequency of more aggressive tumors is higher among younger women.
Because they are outside the screening group (periodic screening with the aim of detecting tumors early) and because of the frequency of more aggressive tumors, the diagnosis is, on average, made at a more advanced stage compared to women who have had tumors post-diagnosis.
There are some other characteristics to consider when diagnosing breast cancer in a young patient: an increased risk of developing metastatic lesions in the breast and that the patient has a genetic mutation that leads to cancer. More extensive or more aggressive surgical treatments are generally not indicated in this age group.
It is essential to counsel younger patients about fertility preservation methods to resume maternity planning after completion of cancer treatment. In any case, there must be an agenda for individualization of diagnosis and treatment, case by case.
We must be careful to use the effective resources available to treat the tumor, without the treatment being more harmful than the disease itself. For this and other reasons, I’m a supporter of SUS and Absorbing Medicine, so everyone has access.
*Dr. Jimenez, deputy and state doctor, [email protected]
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