An early diagnosis
No woman ever expects to be diagnosed with breast cancer, but Jennifer Kehm especially never thought she’d hear those words in her 30s. “I was diagnosed at the age of 36,” she said. “I have no family history of it, so it was a shock. I thought the doctor was wrong actually – I kept questioning him.”
Kehm had a lumpectomy, then underwent a mastectomy two weeks later due to more cancer than expected. In all, the Venetia resident had three tumors and battled the disease while trying to care for her three young sons all under age 5. “The cancer had traveled out of the breast into three lymph nodes under my arm,” Kehm said. “I had four treatments of one chemotherapy drug then four treatments of another that spanned six months.”
One of Kehm’s biggest frustrations was that she couldn’t find anyone her age who had gone through the same experience. “The majority of women diagnosed are post-menopausal, so it was difficult to find research or support groups for my challenges,” she said. “I only knew women over 60 with breast cancer. I felt isolated. It was hard to ask them questions about how to talk to my young kids, and the medicines at that time were mainly tested on post-menopausal women.”
The issues younger breast cancer patients contend with can be very different than that of someone over age 50 or 60. For instance, women of childbearing age who are fighting breast cancer may also be pregnant or worried about whether chemotherapy or other treatments will affect their future fertility. Kehm says there’s also an emotional toll that breast cancer and reconstructive surgery can take on younger women regarding their sexuality. “How do you tell your date when you are 25 years old that your breasts were removed,” she asked. “It’s hard to wear bathing suits or low-cut shirts. It takes time to get used to your ‘new body’ and most young women go into menopause during or after treatment, along with all the hot flashes and symptoms.”
Kehm explained that cancer and treatment also interrupt work and are a financial burden for many families and especially for single mothers. “Many of the ladies I have worked with over the years had exhausted time off from recent maternity leaves – not to mention having young babies,” she said.
Dr. Michael Cowher is a breast surgeon with Allegheny Health Network and says each woman’s experience is different. “Younger women may have unique concerns such as being earlier in their careers, concerns regarding preserving their appearance and sexuality, raising (or planning to have) a family, and possibly having fewer friends their age who have had a major health problem,” he said. “On the other hand, younger women typically have less other pre-existing health problems and they often bounce back more quickly from treatments such as surgery, chemotherapy and radiation.”
Cowher said that while only about five percent of patients diagnosed annually with invasive breast cancer are under age 40, their types of cancer tend to be more aggressive. “They do tend to present with more aggressive types of cancer, more biological subtypes, such as high grade and hormone receptor negative tumors,” he noted. “The reasons for this are currently the subject of important and intense scientific study.”
Cowher urges younger women to be aware of their individual risk of breast cancer and advises them to discuss their risk and family history with their primary care doctors. As far as when to begin mammography screening, that topic is still up for debate. He recommends women with a normal breast cancer risk start at age 40. “If they have a family history of young breast cancer, I recommend screening begin at five years younger than the family member was diagnosed.”
Kehm is healthy today and her sons have grown into young men ages 17, 19 and 21. But her difficulty finding answers and advice on some of the issues she was experiencing as a young breast cancer patient made her realize there’s a need for more targeted support. She decided to start a group to offer information and support to breast cancer patients under age 45. That’s how the Young Women’s Breast Cancer Awareness Foundation was formed. The group offers information on breast cancer and treatment options as well as counseling and support groups to help younger women navigate through treatment and its accompanying emotions. “Any breast cancer diagnosis is isolating and scary,” Kehm said. “Support groups might sound intimidating, but finding someone who has gone through it has made a huge difference. It will really help.”
For more information on the Young Women’s Breast Cancer Awareness Foundation, visit www.ywbcaf.org.