Breast Cancer Awareness for the Under 40s

In the US alone (22nd on the list of countries with the highest rates of breast cancer), more than 4% of women diagnosed with breast cancer are under the age of 40. However, routine screening is only recommended after the age of 40 except for women with a family history. Cancer in the under 40s is more aggressive and it also tends to be diagnosed at later stages.

October is Breast Cancer Awareness month. It is hard to go far without seeing ads from healthcare facilities and bodies talking about the importance of screening, people walking around with a pink ribbon on their lapel, and numerous initiatives to attract attention to this important disease.

However, I believe that more information is needed. Take the example of male breast cancer. This year I was bombarded from all sorts of sources with information about how men can also get breast cancer (who knew?). It appears that less than 1% of men will develop breast cancer, and despite this statistic the media focused on this aspect. Yet in the US alone, more than 4% of women diagnosed with breast cancer are under the age of 40, however routine screening is only recommended after the age of 40, even though the number of younger women developing breast cancer is on the rise. Consequently, since cells develop faster the younger your body is, cancer in the under 40s is more aggressive and it also tends to be diagnosed at later stages.

In my small circle of family and close friends, I can count four cases of breast cancer. Two of whom are female friends both of whom are well under 40, and still child bearing age. (The others were caused by extended use of HRT in one, and late diagnosis in the other).

Little known facts about breast cancer

-          Younger women have a higher mortality rate and a higher risk of metastatic recurrence (ie the breast cancer spreads to other parts of the body). According to the American Cancer Society, in 2017 2% of deaths caused by breast cancer occurred in the age group of the under 40s, compared to 9% of deaths in the 40-49 age group. However, the percentage of total diagnosis for these age groups is 3% and 20% respectively.


-          In the 15-39 age group in the US, approximately 700,00 men and women are diagnosed with some form of cancer each year. Out of these 15.2% of women are diagnosed with breast cancer, the second most common type of cancer after skin cancer.


-          In the US 1 in 8 women will be diagnosed at some point in their life.


-          The risk factors are not just genetic, and are increasing.


-          Lumps are only one potential symptom of breast cancer. There is a long list of other symptoms.


-          Mammograms are not the only, or safest way, to screen for breast cancer.


-          Men have a much higher mortality rate than women due to two factors. As a group there is less awareness, and men also delay going to the doctor and seeking treatment.


-          Alcohol consumption (even a single glass a day) greatly increases the risk, perhaps more so than smoking or being overweight.


-          You can get breast cancer even while you are breastfeeding or during pregnancy.

The above statistics are for the USA. Scary enough as they are, according to the World Research Foundation, in 2018 the USA was only 22nd on the list of the highest rates of breast cancer per country.  This means that there are 21 other countries with much higher rates!

Highest Rates per Country – the top 25 worldwide

1 Belgium

2. Luxembourg

3. Netherlands

4. France (metropolitan)

5. New Caledonia (France)

6. Lebanon

7. Australia

8. U.K.

9. Italy

10. New Zealand

11. Ireland

12. Sweden

13. Finland

14. Denmark

15 Switzerland

16. Montenegro

17. Malta

18. Hungary

20. Germany

21. Iceland

22. USA

23. Canada

24. Cyprus

25. Samoa


Can you see your country of origin in this list?


Risk factors contributing to breast cancer

We all know that a family history of breast cancer is believed to be the greatest risk factor. If your mother, sister, father or child had breast cancer, especially before the age of 50, then you will probably be advised to start early screening for breast cancer (under the age of 40).

 For the rest of the population, and especially for many who depend on expensive diagnostic testing to be approved and paid for by private insurance or governmental guidelines, you are expected to self screen or be checked manually at your routine annual gynaecological check up (that is, if your doctor includes this).  However, as I mentioned before, the presence of a lump is only one of many different symptoms that may, or may not manifest.  Just as there are different types of breast cancer, starting in different types of breast cells, not just in the milk ducts or glands, so there are different symptoms. More on this later.

Let’s look at other risk factors (and oestrogen predominance):

1.       Cancer in general, can develop due to exposure to radiation. This is why a couple of years ago my doctor refused to prescribe a mammogram except every other year because “I you don’t have it, with radiation you will develop it”. However, according to the American Institute for Cancer Research’s Continuous Update Project, the effects of radiation are not immediate and may take 8 to 35 years to manifest ! That means that an x ray for a broken bone taken in your youth, could turn your cells into cancerous cells in middle age or later.

2.       DES, or diethylstillbestrol, which was often given between the 1940s to 1960s to pregnant women to prevent miscarriage, can increase the risk by 30% in both the mothers and their offspring later in life.

3.       Shift work, and night shift work in particular, such as for nurses and flight attendants, which leads to disrupted circadian rhythm and the exposure to artificial light at night, has been linked to a much higher risk.

4.       Alcohol consumption of as little as one drink (10g) consumed every day can increase the risk by 7-10%. However, the risk jumps to 20% when 2 or 3 drinks a day are consumed. Alcohol consumption leads to an increase in oestrogen and androgen levels, and breast cancer is directly related to an oestrogen imbalance (too much oestrogen in the body).

5.       Similarly the use of contraceptives such as the pill, HRT therapy and other hormone based treatments can also lead to breast cancer.

6.       Smoking, especially long term smoking and in particular if this started before the first child was born, carries a 21% higher risk.

7.       Environmental factors such as pesticides and industrial chemicals (hormonal disruptors) can also create hormonal imbalances which can eventually lead to breast cancer.

8.       Being overweight or obese has also been directly linked as the cause of 12 different types of cancer (oesophagus, pancreas, liver, colorectum, kidney, endometrial, mouth, pharynx and larynx, stomach, gallladder, ovarian and prostate cancers, as well as breast cancer in post menopausal women). This risk increases if body weight increases in adulthood especially in cases of breast cancer and endometriosis. It is estimated that in 2016 there were 1.97bn people adults and 338 million children and adolescents worldwide who were overweight or obese. A figure which bears thinking about.

9.       Diet also plays a role. I am not going to remind you that the plant-based diet is best. Nor that red meat consumption or dairy should be reduced, and sugar avoided.  Instead I am going to give you some information you may not have heard before.  During a 2009 study into additives, Italian researchers found that 4-hexylresorcinol, an additive used to prevent  discoloration and increase the shelf-life of shrimps and other shellfish, possess oestrogenic effects. This alone should be sufficient reason to stay away from shrimps or any processed foods.

10.   Similarly, propyl gallate, which is a preservative used to stabilise fats and oils and stop them from going rancid in products such as chewing gum, chicken soup bases, processed meat products and vegetable oils, has also got oestrogenic effects.

11.   The same is true for Phthalates found in synthetic scents, candles, make up and nail polish, to name a few.

12.   Even essential oils such as jasmine, clary sage, geranium, lavender and tea tree oil have oestrogenic properties.

13.   The BPAs in canned foods and drink and the PET in plastic bottles also increase oestrogen.

(for a more in depth look at women’s hormones please refer to an earlier blog post here).


The symptoms of breast cancer

The most recent friend under 40 who underwent a double mastectomy earlier this year told me “They all say that breast cancer will hurt, but I felt no pain. I just found a small lump which then got bigger, but never any pain”. The fact is, every woman is different and may or may not experience any or all of these:

-          Swelling

-          Skin irritations, scaly, red or thickened skin on the breasts

-          Pain

-          Nipple retraction

-          Nipple discharges

-          Changes in the size, shape or colour of the breast

-          The presence of lumps

Diagnosis and treatment

Not all lumps are malignant. In fact most lumps are benign. Also, as many women know, the breast tissue just before menstruation feels more lumpy and one of the most common symptoms of PMT is sore breasts (incidentally this is due to a change in the oestrogen levels, and it is why clary sage essential oil can be good at relieving symptoms of PMT).

a.       (self) breast examination. This should be done monthly, before getting out of bed, with your arms over your head, and just after your period.

b.      Mammogram – effectively an X ray of your breasts and the most common type although perhaps the least safe of all the screening methods,  and is not that accurate.

c.       Ultrasound – to look deep within the body tissue. This is currently only used for women with complex or dense breast tissue, in conjunction with a mammogram. However, it is safe as it involves no radiation.

d.      Biopsy – the removal of a lump to examine whether or not it is malignant.

e.      MRI one of the safest and most accurate methods of screening. It is carried out by injecting a dye and involves no radiation. It is also more comfortable as the patient lies on their stomach and the breasts rest rather than being compressed. Unfortunately it is generally only used to screen higher risk women due to the costs involved. Why not use it to screen all women especially younger ones?

Treatment methods can vary according to the severity and stage. It can go from surgery to remove the lump or a full mastectomy (removal of part or whole breast), followed by radiation therapy and or chemotherapy, or just hormone therapy (which effectively throws the woman into an early menopause).

How to detox from excess oestrogen naturally

The following are just a few suggestions to decrease excess oestrogen in your body:

i.                     Take a milk thistle supplement

ii.                   Take a dandelion supplement or take it as a herbal tea infusion

iii.                  avoid plastic (and PET) containers for storing and cooking food and drink

iv.                 avoid non-stick cookware

v.                   consume fresh (or frozen) foods instead of canned foods

vi.                 lose weight (oestrogen is stored in fat)

Breast cancer from an emotional perspective

According to holistic and traditional medicines, breast cancer is caused by unresolved emotional issues, namely to do with undealt with grief or mourning.   This in itself can lead to higher levels of stress.

The link between dairy consumption and cancer

It is also believed that a diet high in diary products especially milk can lead to hormonal imbalances and disease, including cancer.  Interestingly, when I looked for the statistics of the countries with the highest per capita consumption of milk, it would be easy to make the link between these and the statistics of the countries with the highest rate of breast cancer in women (it bears thinking about).

Countries with the highest consumption of milk and dairy products (source: world atlas website)















































And although soy is a much discussed food, and would warrant an entire blog post in itself, countries where women consume soy daily, and consume no dairy come low in the breast cancer list.

The complications of breast cancer survivors (for younger women)

These go from early menopause brought on by the (hormonal) treatment, issues with fertility, issues with intimacy and sexual dysfunction, an increase in anxiety and depression, and the added pressures of coping with breast cancer and having to care for (young) children at the same time.

The importance of awareness, screening and prevention

If this is not enough to get women of all ages to take more care of themselves and insist on getting screened (perhaps with MRIs?), I don’t know what is.

I’ll leave you with this thought. One of the most shocking things I read when researching for this blog, was the statement on the National Breast Cancer Foundation website which read: “breast cancer can’t be prevented”. I am still reeling.

There are many things that women, and men, of all ages can do to prevent diseases of all sorts.  A genetic predisposition should be just one more reason to lead a healthy lifestyle. Just because we carry a gene it does not mean this will necessarily develop into a disease and there is an entire new field of research called Epigenetics which directly contradicts the claim made on the website mentioned above.   All I can say is, exercise, eat well, and live your healthiest life. You cannot control everything, but you can definitely give your genes a run for their money!

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