When Young Women Have Breast Cancer–Understanding Their Needs

Hearing the words “you have breast cancer” is difficult to fathom at any age. Now, imagine a patient in her 20s — perhaps still in school or starting a career, not even thinking about having children or fertility — hearing that diagnosis.

To gain more insight into the experiences of young women with breast cancer, two oncology nurses, Carolyn Phillips, MSN, RN, ACNP-BC, AOCNP, and Ashley Henneghan, RN, BSN, MSN, from the University of Texas at Austin School of Nursing recently examined the experience of three young women aged 24 to 28 with stage 3 breast cancer. Women who had completed chemotherapy six months to 10 years prior were recruited from a larger observational study.

“What we found was that this population has a lot needs that were similar to the adolescents and young adults (AYA), but they still had a lot of needs that were similar to women in their 30s and 40s,” Phillips said during a poster session at the 42nd Annual ONS Congress.

“They were just starting to get their independence. They were just starting to get out. But then they were diagnosed with breast cancer. They had to go back and live with their families; this was supportive in one way, but it’s a big loss of independence in another,” she continued.

Through semi-structured interviews with the women, the researchers determined that they had difficulty in seven different areas:

• Maintaining normalcy
• Premature family planning
• Impact on future planning and outlook
• Impact on relationships
• Differences from older women with breast cancer
• Cognitive deficits
• Worry

Regarding normalcy, the young women felt as if they missed out on opportunities that people their age get to experience, such as being able to go out with friends or party.

The women talked about having to make a decision about fertility before they were developmentally ready. Phillips added that some weren’t in committed relationships or were just in the beginning of one and didn’t want to have that conversation.

One woman was quoted in the study, “Being in my 20s and thinking about freezing my eggs was also really weird. I had to grow up pretty fast.”

Diagnosis of cancer at a young age can also lead a patient to change their view of the future, such as will they even live to see it?

Relationship impact was reported both as negative and positive. In some cases, the women developed deeper relationships with family and friends, whereas some felt ambiguity in their relationship with their parents.

In addition to these needs, the women experienced an emotional toll, too; for example, they felt as if older women with breast cancer got to “live their lives” before diagnosis.

“Older breast cancer survivors have their life set, and in your 20s everything is up in the air, thinking about how the future will be…older women already know what their future is,” another woman said in the study.

Cognitive issues were also one of the reported challenges for the women. They reported difficulty with concentration, learning new information, focus and comprehension following diagnosis and treatment.

They also stressed feelings of worry. These thoughts happened regarding their bodies, fear of recurrence, going back to work and feeling like a burden.

The researchers noted that AYA patients with breast cancer are at a distinct developmental stage compared with older patients and have unique needs.

“This population of women in the 20s is one where there haven’t been a lot of studies, so we need more information about how to meet their psychosocial needs and, I imagine, the physical needs as well,” said Phillips.