Adolescents, Breast Cancer, and the Debate about EARLY

At what age should women become aware of the risk of breast cancer and learn how to perform breast self-examinations? This question appears to be at the heart of debate surrounding the Breast Cancer Education and Awareness Requires Learning Young (EARLY) Act, legislation under Congressional consideration that would support a public health campaign for breast cancer awareness in women as young as 15 years of age.

The Susan G. Komen Foundation and the Breast Cancer Network of Strength, two respected national non-profit organizations, support the bill. I certainly have known women who experienced breast cancer at 19 to 25 years of age, as have other people who work in support of breast cancer programs. Kristina Applegate is our most recent poster child for breast cancer survivor that is not yet 40 years old, and she reportedly discovered her cancer through MRI. This kind of diagnostic is, of course, pricey for most women, even for the majority of those with health insurance.

However, the bill has a substantial amount of opposition, with some opposing viewpoints being expressed by other cancer organizations, such as the National Breast Cancer Coalition (NBCC), who point out — and rightly so – that we don’t know enough about breast cancer in women under 40 to make a positive impact with the money attached to the EARLY Act. In fact, they argue that a broad awareness campaign like the one proposed may actually hurt more than it could help.

Because I care deeply about breast cancer and can see both sides of the argument, I took notice of a report on MinnPost.com indicating that the EARLY Act language has recently been altered enough to get the endorsement of the American Cancer Society. It has been passed in the House, but is not expected to fair very well in the Senate.

Part of me wants to say that any information is better than no information, and regardless of whether or not we can confidently approach the issue of early detection in adolescents and young adults, orienting women at a young age to the concept of breast health could be a good thing. But as a pediatrician, is this an issue you’re prepared to take on in your own practice?