Breast Cancer Diagnoses Rising Among Younger Women
In the past year, several young celebrities have openly shared their experiences with breast cancer, serving as a poignant reminder that the incidence is increasing in women under 50 in the U.S.
This week, pop singer Jessie J, at 37, announced on Instagram that she’s been diagnosed with early-stage breast cancer and has plans for surgery soon. Katie Thurston, a former star of “The Bachelorette,” has been candid about her struggle with Stage 4 breast cancer after being diagnosed at 34 earlier this year. Additionally, Danielle Fishel, known for her role in the ’90s sitcom “Boy Meets World,” shared her diagnosis last summer at the age of 43.
The frequency of new breast cancer cases among younger women has notably risen over the last decade. Between 2012 and 2021 — the last decade with available data — the annual rate increased by 1.4% for those under 50, contrasting with a 0.7% increase in women aged 50 and older.
This trend is consistent across all racial and ethnic groups, but it’s particularly pronounced among Asian American and Pacific Islander women, with diagnoses increasing by nearly 50% since the year 2000. Among younger demographics, Black women face the highest rates of breast cancer before age 40 and are also more likely to succumb to the disease.
Typically, women under 40 aren’t routinely recommended to have mammograms, unless they possess significant risk factors like family history or genetic predispositions. In such instances, the American Cancer Society advises starting mammograms at age 30, along with annual breast MRIs.
Medical professionals stress that younger patients and their doctors must be vigilant about symptoms such as lumps or unusual discharge. Dr. Rani Bansal, an assistant professor at Duke University School of Medicine, pointed out that there’s been a tendency to dismiss breast changes in young women as trivial. She notes, however, that with an increasing number of younger women being diagnosed, the medical community must take these situations more seriously.
Dr. Oluwadamilola Fayanju, chief of breast surgery at Penn Medicine, stated that her youngest patient was just 17 years old at the time of diagnosis. She recommends that young women with concerning symptoms consult with specialized breast imaging centers.
For those at a heightened risk of breast cancer, she advises connecting with a dedicated breast care provider for regular check-ups, possibly even before they reach 40.
Breast Cancer in Young Women is Often More Aggressive
Advancements in treatment have led to improved survival rates among younger women diagnosed with breast cancer, with mortality rates declining from 2010 to 2020, as highlighted in research presented at a conference in Chicago earlier this year.
Nonetheless, young women still encounter a higher likelihood of aggressive breast cancer types compared to their older counterparts. One reason might be the lower rates of screening, which can delay early detection. Younger women are also disproportionately affected by triple-negative breast cancer, known for its rapid spread and limited treatment options.
Dr. Virginia Borges, a medical oncology professor at the University of Colorado Cancer Center, explained that women diagnosed with breast cancer before the age of 35 generally face a greater risk of the cancer spreading, though the exact reasons are still unclear. She describes it as a complex puzzle of various factors.
Bansal added that there’s a growing need for more data to tailor treatments specifically for women under 50, as most existing studies focus on older populations.
Lifestyle, Environment, Hormones
The increase in breast cancer diagnoses among younger women remains murky, as many contributing elements likely interplay, including lifestyle, hormones, and environmental exposures.
Dietary habits leaning toward ultra-processed foods and insufficient physical activity may lead to obesity, a known elevating factor for cancer. Women in their 30s and 40s have also been consuming more alcohol in recent years, which is linked to breast cancer.
Environmental toxins like air pollution and chemicals might also be influential.
As suggested by Suzanne Price, CEO of Breast Cancer Prevention Partners, past exposure to certain household items could have long-term effects. She noted that when today’s middle-aged women were infants, many baby bottles contained BPA, and Teflon cookware was commonplace.
More research is necessary to firmly establish these links, according to several experts.
Dr. Adetunji Toriola, a surgery professor at Washington University School of Medicine, expressed hope that within the next few years, more insights into early-life exposures will emerge in relation to breast cancer risk.
Some studies have pointed to chemical hair straighteners, widely used by Black women, as a potential factor in increased breast cancer risk. Fayanju mentioned that these products might disrupt how hormones function in the body and their interaction with breast cell receptors.
Changes in women’s reproductive cycles could also factor in. For instance, U.S. girls are starting their periods earlier than in previous decades, which may extend their exposure to high estrogen levels—a hormone that can sometimes fuel cancer growth. A recent study indicated an uptick in women aged 20 to 49 diagnosed with estrogen-responsive breast cancer.
Moreover, many women are now choosing to have children later in life, which has been linked with a rise in postpartum breast cancer cases—those occurring within five to ten years post-birth—related to physiological changes during that period. Borges estimates there are approximately 18,000 new postpartum breast cancer cases annually.
“How do we differentiate the millions of women who have children from the 18,000 who develop these types of breast cancers?” she pondered. “We’re still trying to piece that together. Age clearly plays a role.”
