August 04, 2008

MONDAY, August 4, 2008 ( — Christina Applegate, the actress who played Kelly Bundy on the sitcom Married With Children from 1987 to 1997, has breast cancer and is undergoing treatment for it at age 36.

While breast cancer is rare in younger women, the disease can strike at any age. (Take our quiz to find out more about breast cancer risk factors.)

Applegate was diagnosed at an early, very treatable stage, according to Ame Van Iden, her publicist. "Benefiting from early detection through a doctor-ordered MRI, the cancer is not life-threatening,” Van Iden said in a statement. “Christina is following the recommended treatment of her doctors and will have a full recovery."

Do most women need to worry about breast cancer in their 30s? "No," says Debbie Saslow, PhD, director of breast and gynecologic cancer at the American Cancer Society, "unless they have a strong family history, and even then the risk is still low."

Only 4% of women diagnosed with breast cancer every year in the United States are under 40, but that still represents 8,000 women, she says. "If a woman finds a lump, she still needs to go to a doctor and not be told, 'You're too young to have breast cancer.'"

In young women, breast cancer may be more advanced
While it’s less common, cancer in younger women can be more advanced (and potentially more aggressive) at diagnosis than it is in older women.

Khadijah Carter, 33, is a breast cancer survivor who discovered a lump at age 28. It took five months before her cancer was diagnosed.

Most lumps in younger women are benign, so they “are kind of dismissed or there is no sense of urgency to have follow-up tests,” says Carter, who is the diversity-and-programs manager for the Young Survival Coalition, a group that connects young breast cancer patients around the world to other survivors.

Carter’s cancer was at stage III when she was diagnosed, and she underwent a mastectomy and chemotherapy at the time.

Due to denser breast tissue in younger women, and the rarity of cancer, most women without a family history of the disease don’t have routine mammograms in their 20s and 30s. (The American Cancer Society recommends annual mammograms for women starting at age 40).

Although there’s been some debate about the ability of breast self-exams to reduce mortality, they’re still a good idea if they are done properly, experts say. They are one of the few cancer-detection methods available to young women without a family history of the disease.

“Even women who are not diagnosed—know your body,” says Carter. She recommends that you “don’t take no for an answer. If you don’t feel comfortable with what your doctor is telling you, go for a second, third, or fourth opinion if you feel you need to.”

Family risk of breast cancer
Risk factors for early breast cancer include having a BRCA gene mutation. However, less than 10% of breast cancer is hereditary, according to Carter.

Women with a family history—a mother, sister, or daughter with breast cancer, not a distant cousin—may need to begin routine screening earlier than age 40.

"Cancer is essentially a disease of aging, though [it] can and does occur in young women," says Ann Partridge, MD, MPH, director of the Program for Young Women With Breast Cancer at the Dana-Farber Cancer Institute in Boston. "Outside of known hereditary predisposition—for example, BRCA–1 or –2 mutation carriers—it is usually not known why any given young woman gets the disease."

Applegate’s mother was reported to have been diagnosed with breast and cervical cancers, “so she was probably being monitored,” says Carter. If you have a family history of the disease, the age when screening starts may vary as well as the type of test used.

Several tests are used to diagnose breast cancer, including:

Magnetic resonance imaging (MRI)

If a woman has a family history of relatives with breast or ovarian cancer, she should get a whole genetic workup, according to Saslow. If you are found to be at high risk, you should start screening at age 30 and have both routine mammograms and MRIs, Saslow says.

Special concerns for younger breast cancer patients
If you are diagnosed with breast cancer, one of the first things you should do is assemble a good medical team, says Carter.

And she notes that younger women have several issues that differ from those of older women.

“A lot of young women are just at the beginning of their careers, maybe not married yet, or just newly married or have young children, so it's a matter of dealing with intimacy and relationships, sexuality and body image, and fertility,” she says.

Carter recommends an organization called Fertile Hope for cancer patients who are concerned about posttreatment infertility. “I think that it’s important for young women to have information about freezing their eggs in case they want to have children after treatment,” she says.

Applegate is involved with breast cancer research and is scheduled to appear in a one-hour television special on September 5 called Stand Up to Cancer, which will raise funds for cancer research.

“I’m sorry to hear about her diagnosis,” says Carter. “Hopefully she’ll have a doctor who can treat the whole person and not just the disease."

By Theresa Tamkins


Related Links:
Breast Cancer Myths
Should I Get the BRCA Gene Test?
2 Women Consider Prophylactic Mastectomy
A Young Athlete With Breast Cancer Asks, Why Me?

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