'Too Young for Cancer': When age delays diagnosis for women with breast cancer symptoms
When my client found a lump in her breast in her early thirties, she was told by the Breast Unit that she was too young for it to be cancer. She is now living with incurable breast cancer and is unlikely to see her two children become teenagers.
In the UK, breast cancer is the most common cancer affecting women, claiming 11,500 lives each year. Routine screening begins at age 50, yet nearly 2,400 women are diagnosed under the age of 39. When women under the age of 40 present with a suspicious lump they are not given a mammogram, recognised as the gold standard in breast cancer screening, but a less effective ultrasound.
Having been instructed by two young mothers with strikingly similar stories of dismissed symptoms and delayed diagnosis resulting in late-stage cancer, I am extremely concerned that women’s lives are being put at risk due to their age.
Miss C, a doctor, was only 31 when she found a visible lump in her breast. Her GP took her concerns seriously, but at the Breast Unit, the lump was downplayed. She was told, as so many young women are, that she was “too young for cancer.” An inconclusive fine needle aspiration was performed, though guidelines called for a core biopsy. She was sent home with reassurances that it was just microcysts.
Six years passed and the lump did not go away. When her breast developed swelling and the “peau d’orange” skin texture often linked to inflammatory breast cancer, she returned to her GP. Again, she was reassured it was probably nothing. But this time, a mammogram and core biopsy confirmed what had been missed all along: Grade 2 breast cancer, already in her lymph nodes and with metastasis to her spine. Later scans would reveal it had spread to her brain. She is now living with incurable cancer and has two children - the youngest is just five years old.
Then there’s Miss L. At 35, she had a strong family history of breast cancer and felt two lumps in her breast. She was referred under the two-week wait system, but the consultant dismissed concerns, saying the lumps felt like fatty tissue. No biopsy was done. Months later, when she noticed a lump in her armpit, her GP prescribed antibiotics and told her to wait six to eight weeks for a scan. She paid for a private scan and was devastated to learn that she had advanced breast cancer that had spread to her lymph nodes, chest, and neck. Retrospective review of her original NHS scan revealed the tumours had been visible all along.
Miss L also has a five-year-old child. Her cancer is aggressive, treatment-resistant, and spreading. She is in the thick of chemotherapy, radiotherapy, and surgeries - fighting for time she might have had more of, if only she had been taken seriously when she first raised the alarm.
Early detection and treatment of breast cancer are vital for increasing survival rates, particularly for younger women, whose breast cancer tends to be more aggressive. A study funded by Breast Cancer Now found cancers were detected sooner when 35 to 39-year-olds at risk had annual mammograms. For women with a family history, removing a non-invasive tumour early is likely to be a cancer preventive.
Campaigns from charities such as Coppafeel and social media messaging from women diagnosed with breast cancer in their 20s and 30s help to encourage more young women to check their breasts. The onus is then on doctors to investigate any concerns with the same urgency reserved for older women.
Stories of lumps being written off as an effect of the contraceptive pill or symptoms such as fatigue dismissed are common. Recently a GP surgery in London implemented mandatory training in women's health after a 33-year-old who complained of nipple discharge was told she was too young for cancer. She wasn't examined at the appointment but was later diagnosed with triple positive breast cancer.
Routine screening is only offered to women over the age of 50, as young women have denser breast tissue that can interfere with the results. This doesn't mean they are not at risk of cancer, but sadly the myth they are remains. Medical misogyny plays a role here too. According to the recent report by the Women and Equalities Committee (WEC) on treatment of female reproductive conditions, younger women are more likely to be accused of exaggerating their symptoms.
Funding is needed for research into effective diagnostic tools for dense breast tissue and medical professionals must be trained to take all possible breast cancer symptoms seriously, despite a woman’s age.
My clients weren’t too young for cancer, they were just too young for the health system to act in time.
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