Properly Educating the Youth about Breast Cancer
In my role as community moderator on this site, I team with my fellow expert patients to answer upwards of 300 reader questions a month. These questions range from the kind-of-ridiculous (“I keep my cell phone in my bra. Is that why my breast is vibrating?”) to the sublime (“What can I do to help my best friend who’s just been diagnosed with breast cancer?”).
By far, though, the largest proportion of questions ask the same thing in a whole lot of different ways:
“Do I have breast cancer?”
From lumps to rashes, dimples to oozing nipples, swelling in the underarm to “something that looks like a bug bite,” women are worried that they have breast cancer.
And it’s not just the women who are worried.
Sadly, there are plenty of girls who write in for help. And I mean little girls: some as young as 10 or 11 years old. They feel a lump; they think they have cancer. Here’s just a sampling of some of the questions we’ve answered lately:
I’m a 15 year old girl, do I have breast cancer? - Marisa
I am 14 years old and I have a small lump on one of my breasts. Is that normal or is it breast cancer? - SB
I’m 13 years old and I have a lump in my right breast. I’m scared it is breast cancer… Is it possible for me to have breast cancer? I’m too scared to tell anyone. And going to the doctors scares me because I have a male doctor. What should I do? - Michaela
I'm a 13 year old girl and I have a lump or tumor in my right nipple. I'm not sure if breast cancer runs in my family. My mom and sister don't have it. Help? – Alysha
I’m 12 years old and I think I have breast cancer. What should I do? - Charie
I want to reach out to these girls and give them a hug, and tell them “NO, you don’t have breast cancer. Now go back to worrying about boys and sports and your homework.”
Yes, I know it’s POSSIBLE to get breast cancer as a young girl; an 11-year-old in California was recently diagnosed. But the chances of a teenage (or younger) girl having breast cancer are statistically 0%. Basically, it's not going to happen.
I feel safe and responsible telling these kids that they don’t have breast cancer – while also encouraging them to bring their concerns to their parents, of course. And suggesting they read our Teen Guide to Breast Development.
Because what’s the alternative? Tell them yes, you could have breast cancer – you need to go to the doctor, get a mammogram, have a biopsy…?
I don’t think so.
My wish for these girls is that their 6th-grade health class would include a 15-minute segment on breast issues during puberty. While the boys go out and learn about wet dreams, the girls can learn about menstruation and, yes, their breasts.
I want the teacher to tell them that the huge media focus on breast cancer – pink October, Race for the Cure, et. al. – really isn’t directed at them. That they’ll see and feel their breasts change during puberty, but that they don’t have to worry about breast cancer – right now.
I want them to know that it’s good to get into the habit of being aware of breast changes – in fact, any physical changes. But that for now, at least, breast awareness is simply good practice for the future. The distant future, since the vast majority of breast cancer diagnoses are in women over 40.
Thus I was happy to hear about the EARLY Act of 2009. Education and Awareness Requires Learning Young is a $45 million bill making its way through Congress. I’d assumed it would educate young women about their risk for breast cancer – virtually nonexistent – with perhaps a heads-up about good preventive practices for the future.
I was wrong.
The bill seeks to “increase public awareness regarding the threats posed by breast cancer to young women.” It’s an all-out effort aimed at breast cancer prevention, risk reduction, and early detection, including genetic testing.
But wait a minute. Only 1 in a million teenage girls will get breast cancer. In fact, only 5% of all breast cancer diagnoses are in women under age 40.
That’s why, good as it initially sounds on paper, I’d vote against the EARLY Act. Because it’s the right message – but the wrong population. This information, aimed at women as young as 15 years old, is akin to showing a 6-year-old how to take care of an automatic weapon in case someday s/he joins the Army.
The American Cancer Society doesn’t support the EARLY Act. The National Breast Cancer Coalition has come out against it. So have Dr. Steven Woloshin and Dr. Lisa Schwartz, professors of medicine at the Center for Medicine and the Media, Dartmouth Institute for Health Policy and Clinical Practice. The authors of Know Your Chances: Understanding Health Statistics, they wrote an incisive column about it that ran in newspapers nationwide earlier this week.
The final sentence of their column is this: “It [EARLY Act] would end up doing more harm than good.”
Judging by the level of fear – needless fear – teenagers (and younger girls) already feel about breast cancer, I’d have to agree.
Aim the message at the group experiencing 95% of all breast cancer diagnoses: women over 40.
And as for the kids – they’ll get there soon enough. Till then, less (information) is more.