Although a breast cancer diagnosis isn’t a rare occurrence in the United States these days — the American Cancer Society projects more than 250,000 new cases will be diagnosed in 2017 — in May 2009, several media outlets reported an extremely rare case of breast cancer.
What made it so exceedingly unusual was that it belonged to 10-year-old Hannah Powell-Auslam of Orange County, California. As news of her story broke, journalists around the country asked how an otherwise healthy fifth-grader could be facing breast cancer. Auslam herself told Good Morning America, “I’m a kid fighting an adult disease.”
By and large, breast cancer is an older woman’s disease. Although ACS reports that breast cancer is the leading cause of cancer death among women ages 40 to 59 in the U.S., only 7 percent of all breast cancers occur in women under the age of 40, and less than 1 percent are diagnosed in women under age 30. The rate of breast cancer occurrence in teenagers and children is so small, it’s virtually incalculable.
[See: 16 Health Screenings All Women Need.]
Why is that? Well, hormones and the typical progression of puberty and age mean that very young women and children are a lot less likely to develop this kind of cancer than they are other types of cancers. And because most breast cancers rely on estrogen to grow, the fact that estrogen isn’t as abundant a hormone in the female body until after puberty means that exposure to this potential trigger is limited in young children and teenagers.
Estrogen’s Role
The ACS reports that 2 out of 3, or about 67 percent, of all breast cancers use estrogen to grow. Estrogen is primarily produced in the ovaries, but can also be produced by fat cells and the adrenal gland. The body uses it to regulate functions, particularly monthly menstrual cycles. Beginning at puberty, the female body begins producing more estrogen, which stimulates the growth of breasts and pubic and underarm hair. Estrogen is critical to female sexual development and fertility; on a monthly basis, estrogen levels rise and fall to prepare the body to support an egg if it’s fertilized or to generate a menstrual period in preparation for the next egg becoming available.
During puberty, breast cells are undergoing rapid division as the breast develops. Although in theory this could mean more chances for a misreading of the genetic code and a resulting tumor, it almost never happens. That’s because young bodies are better at correcting tiny mistakes at the cellular level when they do occur than older bodies are. Dr. Parvin Peddie, assistant clinical professor in the division of hematology and oncology at the David Geffen School of Medicine at UCLA in Los Angeles, says, “your body is pretty good at catching mistakes, especially if the cells are healthy,” which is typically the case when we’re young. She says that the cell division that results in breast tissue growth is a “normal part of development, and the body is pretty good at regulating it.”
[See: 7 Innovations in Cancer Therapy.]
Over time, however, aging means the body becomes a little less good at correcting these mistakes before they turn into cancer. This natural predilection can also be exacerbated by environmental factors, such as exposure to chemicals or pollution, although Peddie says it’s not clear which environmental factors contribute most to the development of breast cancer. “We need more research on which environmental factors are directly linked to breast cancer. We know them for some other cancers like asbestos and mesothelioma, or some chemicals in paint with bladder cancer, or tobacco, obviously, and lung cancer, but breast cancer is more murky. We don’t have clear environmental things other than radiation or somebody being near a radioactive plant, that otherwise might cause breast cancer. We’re still trying to figure that out,” she says.
[See: A Tour of Mammographic Screenings During Your Life.]
What’s more, as your exposure to potential carcinogens in the environment over time accumulates, so does your exposure to estrogen, which can fuel the growth of many breast cancers. Peddie explains that the estrogen isn’t causing the cancer, but can be a factor in its growth. “Normal breast tissue depends on estrogen for growing, and that’s just a normal thing. But some breast cancers — the majority of them — learn to use the same mechanism to their advantage. So they overexpress estrogen receptors, meaning when there’s estrogen around, it feeds the tumor. So the tumor is already there, it just uses estrogen for growth.”
Suffice it to say, the overwhelming majority of girls and teenagers will not have to deal with breast cancer during those years. Nevertheless, it’s never too soon to make the sort of healthy lifestyle choices that have been shown to slightly reduce the risk of developing breast cancer later in life. These include eating right, exercising, not smoking, getting enough rest, managing your weight and paying attention to your body. And, as always, if something seems weird or changes, talk to your doctor.
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Why Don’t Children Get Breast Cancer? originally appeared on usnews.com
