Early puberty may contribute to increase in breast cancer among younger women

Still more younger women are succumbing to the disease, and the physicians are yet to know why.

Breast cancer incidence in women aged below 50 has risen by more than 15 percent in the past two decades, attributable largely to the rise of ER+, a cancer that relies on the hormone estrogen to spread.

ER-positive breast cancer is even more prevalent than ER-negative breast cancer at all ages. Because such form of breast cancer is relatively rare and virtually accounting for the increase of the disease among young ladies, some doctors want a link between more people in the US developing their period early and having their first child at a later age, and the development of this type of breast cancer.

“Postmenopausal women, the levels of estrogen they are exposed to over their lifetimes, are elevated,” Dr. Alexandra Thomas, a medical oncologist at Duke Health said. “That’s probably a big piece of it, but we don’t know why we’re seeing earlier periods.”

Many causes can be attributed to this — obesity, alcohol consumption, genes and certain types of hormonal contraceptives — but now, the link between breast cancer and early puberty in women is also receiving more consideration. The age of puberty for girls has been declining steadily for at least the last few decades, with the sharpest decline among Black and Asian American girls.

“This work is still in the early stage,” says Dr. Adetunji Toriola, a molecular epidemiologist, at the Siteman Cancer Center at Washington University. But we do know from some of our previous work and the work of others that we know some factors that may be responsible. As we are aware, these reproductive factors can be associated with breast cancers.”

Longer life duration, shorter peacetime between instrumental births

This is something that has been considered fact since time immemorial that getting to puberty at an early age put the individual at higher risk of getting breast cancer but there is very scanty data available regarding the-getting breast cancer at whatever age.

In the study called ‘Trends in Age at Menarche Among US Young Girls, 1995-2015’ published earlier this year in the Journal of the American Medical Association, researchers determined that, on average, women born between 1950 and 1969 had their first period at 12.5. A fifth of the ladies had attained menarche; commonly known worldwide as a girl’s first period, before they were 11 years, which is scientifically regarded as early. A very small proportion of such women, only 0.6% were first encOUNTered with menstruation Very early, below the age of 9 years.

First source reveals that the aged of first menstruation among girls born from 2000 to 2005 was 11.7, which is 0.7 years earlier compared to girls born 40-50 years earlier. Other forms of development and maturing also advanced and early and very early menarche raised to 15.5%, 1.4% respectively.

“If you start your period before age 11, you are in a greater risk zone for breast cancer, and now the average age simply keeps dropping,” said Dr. Eleonora Teplinsky, head of breast and gynecologic medical oncology at Valley Health System in New Jersey.

It has been estimated that, for each year’s difference that a girl begins menstruating before another, her risk of developing breast cancer in later years goes up by about 5%. Also favoured by developing the breasts early as well increases the possibility of the breast cancer. The study that was done among almost 50,000 women established that girls who got their first breasts at a youthful age of 10 years increased their likelihood of getting breast cancer some time in their lifetime by 23% as compared to girls who got slightest of breasts at age 12/13.

When a woman begin menstruation, the ovaries secrete estrogen and progesterone hormones into the blood. Both can raise a woman’s risk of the hormone-sensitive types of breast cancer which are usually slower-growing and more easily treatable. The American Cancer stage states that 75% of the breast cancers are hormone reactive with at least progesterone or estrogen.

Also since women are waiting longer to have children, or deciding not to have children at all.

Partridge, 38, a woman breast cancer specialist at Dana Farber Cancer Institute and Brigham and Women’s hospital, said that pregnancy slightly reduces life-time risk of breast cancer contrary to the short-term risk increment when a woman is pregnant.

Even though a woman does not menstrually cycle once she is pregnant, “it’s not proven that the exposure is defined by the number of cycles a person has been pregnant, but the timing of pregnancy is independent of estrogen,” Partridge said.

It might be therefore, related to changes that happen after birth, when a woman’s breast reverts to pre-pregnancy shape. This increased risk is even more so for women who have babies later in their reproductive years.

“Women who have children before age 30 have a decreased risk of long term breast cancer,” Partridge said. “We don’t know why,” Sharp said, “but the older a woman is when she has her first pregnancy, the higher-risk she is in the short term.”

Partridge said he was not sure why, but it would seem that inflammation and DNA repair, both of which are generally associated with the ability to combat inflammation and fix damaged tissue, should naturally be better in younger people.

Everything that is known about Breast cancer in young women

Currently, doctors have not exhausted their efforts in tracing why increasing number of younger woman is developing breast cancer.

This is so because most women are either not bearing children, or bearing them at a very ripe age. They’re not breastfeeding as much, which does increase breast cancer risk. But that’s not all of it,” said Teplinsky to me. They found out that obesity and sedentary lifestyles are the causes but why have we observed this rise in risk at this time alone.

Teplinsky added that a stronger correlation should be established between the environment with such toxins as chemicals called endocrine disruptors, and breast cancer.

An academic article published in Frontiers in Toxicology earlier this year reveals that about 200 chemicals which are known to cause breast cancer are used in food packaging papers including cardboards. Certain recent research works have pointed out that taking estrogen only contraceptive might slightly increase the susceptibility of female breast cancer.

It is possible that obesity could be an additional cause for early diagnosis of breast cancer in younger women because the association is not clear cut. Some of the effects are known to be caused within a society, once they include obesity as the reason early onset of puberty is possible. They discovered that it could double, or even triple, the risk of breast cancer if taken after menopause but this is limited to women with poor blood sugar control and who are also above 50 years of age.

If so it would suggest that obesity probably does not play much of a role in the increasing breast cancer trend among the young women pointed out by Toriola of the Washington University.

Toriola said most of the research studies that are being done on lifestyle risk factors and BC are done on women of all ages and this complicates the identification of age specific risk factors.

He said that other Mexican clinics should also embrace risk-predictive models like Tyrer-Cuzick risk assessment that entails other factors like the early puberty and not just the woman’s financial and family history of breast cancer or gene mutations.

“They are, as inform of a general epidemiology of breast cancer risk in a woman,” Toriola added. “They incorporate in the risk factors and would be a better measure of what steps and tests a woman would require to take.”