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Young Women With Breast Cancer Grapple With Extra Dose of Denial


For five years, the pair had been inseparable, a dazzling combination of contrasting good looks: Gina Shafonsky, the sporty blond; Lynne Stan, an elegant, leggy brunette.

Called the "Salt and Pepper Package" by other models, they booked jobs in Hawaii, San Francisco and Las Vegas, and, in the process, became fast friends.

"It felt like we were sisters," remembers Shafonsky of Newport Beach. "We tried to sell ourselves together as a package, rather than individually. It was a great friendship."

When Stan was diagnosed with breast cancer at age 28, Shafonsky was heartbroken. As Stan withered from the effects of the disease, Shafonsky stayed close.

Stan died Nov. 14, 1992, just one month past her 30th birthday. She was survived by her mother and father, two brothers and a sister. And a dear friend.

Shafonsky, now a volunteer for the American Cancer Society in Orange County, golfed Monday in Stan's memory at a breast cancer benefit in Huntington Beach.

"I thought breast cancer was for older women," she says. "I never knew it could touch someone so young."

Breast cancer, traumatic for women of any age, can be devastating for women in their 20s who may lack the life experiences and sturdy support systems to help them cope with the disease, experts say.

Some young women are learning of the dangers of breast cancer and the importance of self-examination, regular doctor visits and--for those with a family history of the disease--early mammography.

Experts in Orange County are trying to help by offering awareness programs and a new support group targeting young women.

"Even though they are very small in number, (young women with breast cancer) are very important," says Hoda Anton-Culver, director of cancer surveillance at UC Irvine. ". . . The number of years lost, the severity of the disease, the fact that it's . . . more (often) hereditary, make them more important to be looked at for prevention and control."

The American Cancer Society says one in nine women will develop breast cancer in their lifetime and 46,000 women will die of the disease this year. The chances of contracting it depend on a variety of factors, including age and family history. One percent of all breast cancer victims are men.

The risk of breast cancer increases with age. Young women, feeling less threatened by the disease, may slough off regular self-examinations and recommended checkups by their doctors, experts say.

In addition, mammography--the most powerful tool for early detection of breast cancer--is less effective in spotting potential cancers in young women, because their breast tissue is so dense.

Experts disagree about what risk factors should prompt young women to have early mammographies.

Dava F. Gerard, medical director of the Breast Health Center in Santa Ana, says young women should consider themselves in a higher risk category if they have a sister or mother with the disease. Young African American women also have a higher incidence of breast cancer, she says.

Anton-Culver, who is also chief of epidemiology at UC Irvine's Department of Medicine, says women should also take into consideration an incidence of breast cancer in aunts and grandmothers, on either side of the family.

These young women, she says, should pinpoint the age that their relative was diagnosed and schedule their first mammography 10 years before that age.

Although it is an imperfect tool for cancer detection in young women, that X-ray technique, combined with a careful breast examination, offers the best chance at early detection, she says, adding:

"If a young woman has a positive familial history of breast cancer, she should not dismiss that fact. She cannot say, 'I'm too young for breast cancer,' because that is not true."

American Cancer Society statistics say one woman in 2,426 will develop breast cancer by age 30; by age 50, that risk rises to one in 52.

Although the incidence of breast cancer is lower for young women, the stakes may in some ways be higher. Since young women often do not consider themselves breast cancer candidates, they may be diagnosed at a later stage when the disease is more aggressive and the mortality rate is higher, Anton-Culver says.

"It's so shocking when it happens in women that young," says oncology nurse Nancy Raymon. "It doesn't fit the norm." Raymon launched a breast cancer support group at Western Medical Center in Santa Ana this month. Although the group includes women in their early 40s, it will focus particularly on issues affecting women in their 20s and 30s, she says.

Experts say the disease poses keen emotional trials for young women, who are just beginning to establish their families, careers and romantic relationships. And although husbands are likely to stick with their mates, young boyfriends very often do not.

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