Q&A with Ann Partridge, MD, MPH

Ann H. Partridge, MD, MPH, as told to Alexandra Benisek

On the WebMD Webinar “Diagnosed Under 40: The Unique Effects of Breast Cancer on Younger Women” Ann Partridge, MD, MPH, of the Dana-Farber Cancer Institute and Harvard Medical School, answered questions from viewers about breast cancer risk in young adults, treatment options, recurrence, and more.

It depends on your genetic makeup, the type of breast cancer you started with, and the type of treatment you received. In general, the risk of new breast cancer in the other breast is low for most young women.

We generally encourage both young and older people who are not at high risk of developing a new type of cancer to have breast conservation on the side where the cancer occurred, if possible. They can usually keep their other breast unless we find something wrong.

Clinical trials are a very important way for all of us to learn and improve care today and in the future. It is also helpful for some people to have access to different types of treatments that they would otherwise not be able to access.

I’m a huge fan of joining clinical trials if it’s right for you and if that trial makes sense for your disease state. I recommend that you talk to your oncologists and other doctors about which clinical trials you may be a part of. You can search for clinical trials here clinical trials.orgor through advocacy organizations and other websites.

In general, I recommend all young women, as well as some women over 45, to get tested. Any woman concerned about her future risks may benefit from testing today.

Testing can also help find out if your family has a high risk of breast cancer, even if you don’t have a known genetic mutation in your family.

We generally don’t recommend thinking about testing for a BRCA1 or BRCA2 mutation until your mid-20s. But if you’re interested earlier, talk to your doctor and a genetic counselor.

There is not much data on topically applied vaginal estrogens for the treatment of vaginal dryness and sexual dysfunction. The data available to us yielded mixed results.

It might be safe for many people, but we are not sure. That’s why we often recommend that you try non-hormonal moisturizers and lubricants first, then use vaginal estrogens only when needed (and use them sparingly).

But there are exceptions in some cases, such as lower-risk patients. This is a conversation with your oncologist and gynecologist if you have symptoms.

There are many different endocrine therapy options for most people. These include both aromatase inhibitors and tamoxifen and for younger people. Ovarian suppression is also used more often in higher-risk patients. Tamoxifen alone is a good choice if ovarian suppression causes too many symptoms.

And, of course, you can choose to take less during the entire 5-10 years of endocrine therapy. For higher risk cases, a longer period is recommended based on your preferences and tolerance. However, the concern is that in less than 5 years, you may not be able to reduce the risk with the full benefit.

Because of the fear of recurrence, which is very normal for a young breast cancer survivor, there are many different strategies. These include deep breathing, exercise, and talking to friends, family, or a trusted therapist or doctor.

It’s important to take care of yourself, eat well, get plenty of sleep and cut down on alcohol and caffeine, as this can cause anxiety in people.

Some young mothers can breastfeed after breast cancer. This can happen if they are no longer receiving treatment or have a break in treatment and have breast tissue (including the nipple-areolar complex) left over.

But breastfeeding can be difficult after radiation.

I recommend several sources. First, talk to your doctor and your care team about your needs and concerns about treatment and supportive care.

Second, most cancer centers have social workers who can help with psychosocial issues. There are also many resources on the Internet.

Commonly trusted sources include the Susan G. Komen website, Living Beyond Breast Cancer, the Young Survival Coalition, the American Cancer Society, Cancer Care, and our own site. Dana-Farber is young and strong website.

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