“In the United States, breast cancer is the most common malignant tumor in adolescent and young adult women 15 to 39 years of age, accounting for 14 percent of all cancer in men and women in the age group,” the study states. “The individual average risk of a woman developing breast cancer in the U.S. was 1 in 173 by the age of 40 years when assessed in 2008. Young women with breast cancer tend to experience a more aggressive form of the disease than older women and have lower survival rates.”
Although small, the researchers state that the increase is significant because it involved cancer that had already spread to organs like the liver, lungs or brain by the time it was diagnosed and may indicate “increasing epidemiologic and clinical significance.”
Birmingham oncologist Luis Pineda, MD, says that he, as well as personnel at the UAB Comprehensive Cancer Center and the School of Nutrition, find these statistics concerning. “We are studying the increase in obesity and the rate of diabetes in the U.S., particularly in the southern states, and we think we will see an explosion of cancer, especially cancer of the breast,” he says. “It is a multi-factorial problem, partially cultural, and will evolve as we go through time.”
Pineda says young women today are sexually active earlier and use of birth control pills at a younger age may have an effect on the rise in breast cancer. “Hormones have a lot to do with breast cancer,” he says. “Girls start menses earlier and become pregnant later in life. There are a lot of relationships between hormone status and breast cancer.”
He also cites bad diet and a change in Americans’ lifestyles – less physical activity and increased use of computers and other technological devices –that are making Americans unhealthy. “Studies have shown over time that eating carbs and processed meats has something to do with breast cancer. There is also the concept that sugar feeds cancer, and there is a substantial body of medical literature that says there’s something to it,” he says.
Using a positron emission tomography (PET) scan, researchers have injected cancer cells with glucose and documented that the level of activity in the cells increases. PET scan technology uses radioactively labeled glucose which is preferentially incorporated by active cells. The cells reflect activity that correlates with cancer cells, helping to define location, extent and level of activity. “Studies show an elevation in blood sugar itself feeds cancer, and as people become obese, which causes insulin resistance, they keep higher levels of insulin in their system,” Pineda says. “The higher level of insulin stimulates the oncogene “mTOR” which is known to produce breast cancer.”
Pineda points out that many people eat a lot of carbs and processed foods because they are convenient and often cost less than healthier alternatives. “We eat more calories on this type of diet, and the food goes to fat. We now know that fat cells are not just an energy store, but they are metabolically active and exchange information with the immune system,” he says. “They communicate with t-cells, which are lymphocytes that have major control over cellular behavior and cancer surveillance, potentially allowing malignant transformation and growth.”
Educating people on how to change their lifestyles to prevent cancer has become a mission for Pineda. “We are in crisis in medical care. People think health care is too expensive, but if we can prevent disease it is less costly than treating it,” he says. “We are studying what is happening in Alabama related to what children are eating. Studies show that they are more likely to eat at a fast food restaurant than to eat what grandma is cooking. We want to change the ingredients in their food so they are eating healthier and become more active.”
Pineda says education is the key to changing this culture. “We need to change the food industry. As a society, we are well versed in medical matters, but we still don’t know what is done to the foods we eat,” he says.
No matter the cause of this increase in breast cancer among young women, researchers will continue to study this increase in the disease. “Whatever the cause – and likely there is more than one – the evidence we observed for the increasing incidence of advanced breast cancer in young women will require corroboration and may best be confirmed by data from other countries,” the study authors write. “If verified, the increase is particularly concerning because young age itself is an independent adverse prognosis for breast cancer, and the lowest five-year breast cancer survival rates as a function of age have been reported for 20- to 34-year-old women.”
