Breast cancer prevention: gynecologist warns: “My youngest patient was 28”
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Expanding breast cancer screening could save more lives, but there are downsides. Gynecologist Sabine Miltenberger provides insights into the frequency of breast cancer in different age groups and explains how sensible it is to extend it to younger women.
What are the advantages and disadvantages of expanding breast cancer screening?
The advantages of starting screening earlier (currently at the age limit of 50) would clearly be the detection of earlier illnesses. The first statistical age peak can be seen at around 43 years. Accordingly, I would personally support an examination every two years from the age of 40. I actually send my patients to a breast center at the same time from this age onwards.
The disadvantage is purely economic: the relatively “few” cases are generally cheaper to treat for the health system than screening all women at an earlier age.
How common is breast cancer in different age groups?
Most cases actually occur in the decades in which the screening program takes place: most women develop breast cancer between the ages of 50 and 70. The years of pre-/peri- and menopause are the most important ones because this is when the mammary gland undergoes significant anatomical changes and the cells that have to divide more frequently can also degenerate more quickly.
About the expert Sabine Miltenberger
Dr. Sabine Miltenberger, an experienced gynecologist, completed her medical studies at the Julius Maximilians University in Würzburg between 1993 and 2000. After successfully completing the III. State examination in 2000, she began her professional career in the private women’s clinic Dr. Wilhelm Krüsmann in Munich-Pasing, where she worked until 2004. She then worked as an employed doctor in the Munich practice F5H until 2010. She has been certified as a specialist in gynecology and obstetrics since 2007. Since 2010, Dr. Miltenberger runs her own practice in Munich, Pranner15, and works there as a renowned gynecologist.
Every 10th affected woman is younger than 45 years, every 4th patient is 55 years old or younger. The average age of onset across all age groups is around 64 years.
Unfortunately, in close communication with examining colleagues, we have repeatedly seen very early breast cancer cases, especially in recent years. My youngest patient was just 28 years old at the time of diagnosis.
Why do experts now recommend early breast cancer detection from the age of 45?
In order to enable safe, relapse-free survival for women who are still “too young” for screening and perhaps do not take advantage of the preventive examination offered as part of the general health care offering.
Invitations for a screening examination are sent via the residents’ registration office, so that women who are not receiving gynecological care from doctors are also contacted. The advantages for all those affected by cancer at a younger age should be clearly highlighted here.
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How does the mammography screening program affect breast cancer mortality in younger women?
If we look at “younger women” up to 60 years of age as an age group, the mortality rate has been reduced very well. Meanwhile, 70-80% of women diagnosed survive their cancer. Early detection is our big opportunity here: the sooner even small or local changes in the tissue can be found, the faster treatment can be carried out. And of course the motto here is: the smaller, the better, the earlier it is detected and treated, the better the outcome.
The question of therapy is also relevant from the time of discovery in the course of the disease. When early carcinomas are detected, surgery with follow-up radiation is often sufficient therapy with little loss of quality of life.
Frequently asked questions on this topic
How do I correctly perform a breast self-exam?
The entire breast is felt in circular movements with the fingertips of the opposite hand. The associated hand can be placed behind the neck. Skin contact is particularly good when…
Sabine Miltenberger
Specialist in Obstetrics and Gynecology
What changes should I be aware of when palpating my breast?
Skin changes such as retractions or redness for no reason (such as after a shock hematoma or redness after an insect bite), skin changes in the sense of orange-like skin with large pores and thickened…
Sabine Miltenberger
Specialist in Obstetrics and Gynecology
How often and when in the cycle should I check my breasts?
Gladly once a month or at least once a quarter. For women who still bleed regularly, the breast is best accessible for palpation during bleeding – so it’s easy to remember. Also imaging such as…
Sabine Miltenberger
Specialist in Obstetrics and Gynecology
What signs could indicate breast cancer?
Unilateral hardening/lump formation of the breast, which occurs painlessly. Sudden changes in the skin surface can be assessed just as quickly as secretion from one side of the breast (especially if the secretion is not…
Sabine Miltenberger
Specialist in Obstetrics and Gynecology
This text comes from an expert from the FOCUS online EXPERTS Circle. Our experts have a high level of specialist knowledge in their subject area and are not part of the editorial team. Learn more.