Do young women overestimate/amplify their own personal risk?

I think one of the problems is that people tend to believe what they read on the internet. So if you read symptoms of breast cancer and it fits what you have (even though 10 other benign medical problems also fit) it's easy to believe you have it, without the critical thinking skills that a doctor develops during their many years of training. I think some people are wired to automatically assume the worst case scenario. I have a tendency to do that, and probably would have been someone googling symptoms and expecting breast cancer. Unfortunately I had it. But luckily (I guess??) I never noticed the lump, and then my doctor found it on a routine exam. So I went from everything being peachy to the rug being pulled out from under my feet in less than 48 hours. So I was able to skip the googling.

But yeah, cyberchondria. There's also a tendency I think in younger generations to go to the internet for absolutely everything. So it's second nature to jump on the internet for every little problem, rather than see a medical professional with the skills to properly diagnose. I see this in telehealth too. Skipping seeing a doctor in person because it's easier to do it online. But can they really diagnose without a proper physical exam? I don't know. Maybe inadequate insurance plays a role too, I don't know. Good discussion.

kanji1

In 30 years of practice I believe I only saw 2 or 3 pts in their late 20's and they had DCIS.

Please visit youngsurvival.org, and look at the survival stories and ages.

I was diagnosed when I was 27, with invasive ducal carcinoma. I know of another woman where I work who was diagnosed with invasive ductal carcinoma at age 24. It can, and does happen. And unfortunately, because of age and being dismissed because of the “you're too young for breast cancer" mindset, many young women experience a delay in diagnosis which leads to poorer prognosis.

Age shouldn't be a determining factor in whether or not a woman or a medical professional takes a breast lump seriously.

djmammo:

That chart is for overall cancer incident, not breast cancer, correct?

kanji1:

I was diagnosed at 38, found the lump when I was 36 (radiologist at imaging facility misdiagnosed it as benign) and it may have developed sometime between 31 and 34.

I have read that less than 5% of breast cancer are diagnosed in women under 40, but the key word here is diagnosed. Those diagnosed in their very early 40s likely had breast cancer in their late 30s.

If you put my prediagnostic information in to the breast cancer risk calculator on cancer.gov, it will tell you that my 5 year risk is 0.4% and my lifetime risk is 11.3% but due to my family history and other factors, in my head I put my odds of developing breast cancer at 50% due to my family history.

I think that calculator on cancer.gov has too many short comings to be used as an official predictive tool...the imaging/biopsy facility I went to used it or a similar calculator and decided to print my 0.4% 5 year risk and 11.3% lifetime risk on the same reports that essentially said I had breast cancer. I guessed they figured I could use a laugh.

The lump that turned out to be cancer wasn't a lump I could feel for a long time. It was new and was in my upper outer quadrant which had previously had no palpable lumps.

What tests have they done on the lump that worries you?

WC3

I've replaced that graph with a better one.

The doctor that examined my lump thought it was benign and I had to wait a month to do mammogram, ultrasound and biopsy. He should have made my case a priority instead of thinking I'm too young. I really hope someone told him that he made a mistake. If there is a lump or anything else weird it should be checked. No matter what age the patient is.

WC3

A benign cyst can be tense and feel very hard like IDC or it can be fairly soft like a colloid carcinoma. Lobular carcinoma can often feel like fibrocystic tissue. I trust the US more than my physical exam and I hold a Level III Certificate in Clinical Breast Examination from the NCoBC.

As far as density is concerned it is a requirement for us to include the patient's density in every mammo report and in the required lay letter that is mailed to every patient explaining their mammo findings. Every report I have ever seen also includes the disclaimer that dense breast tissue can obscure small abnormalities. Some states have instituted laws requiring the listing of options for further evaluation of dense breasts and other states require their insurance companies to pay for any additional imaging required to evaluate dense breasts even in the absence of a lump.

djmammo:

I didn't receive a letter the first time, only the second time. I really wish they would have recommended an MRI or biopsy the first time and I'm not sure why they didn't, given the density of my breasts, family history, that it was a new lump and in my left breast, upper outer quadrant, where I had no other palpable lumps.

They just told me it was normal breast tissue. I asked if I should have it rechecked in 6 months or a year and I was told no, not unless I noticed any changes, but by the time changes were apparent to me it was almost 3cm. It had been growing more towards the inside of my breast than the outside, and downwards in to a denser region which had always been lumpy so I really only noticed a difference when it got big enough to buldge on the outer side.