Breast Cancer in Young Women
Are women under 40 at risk for breast cancer?
Younger women generally do not consider themselves to be at risk for breast cancer. However, breast cancer can strike at any age: 5% of breast cancer cases occur in women under 40 years of age. All women should be aware of their personal risk factors for breast cancer. (A risk factor is a condition or behavior that puts a person at risk for developing a disease.)
There are several factors that put a woman at higher risk for developing breast cancer, including:
- A personal history of breast cancer or a high risk lesion found by biopsy
- A family history of breast cancer, particularly at an early age
- A family history that is concerning for a genetic syndrome that may put them at a higher risk for breast cancer (breast cancer diagnosed before age 50, ovarian cancer at any age, triple negative breast cancer, bilateral breast cancer, male breast cancer, pancreatic cancer or metastatic prostate cancer)
- History of radiation therapy to the chest
- A known genetic mutation conferring a high risk for the development of breast cancer
- Ashkenazi Jewish ancestry (one in 40 Ashkenazi Jews carry mutations in BRCA1 or BRCA2)
What is different about breast cancer in younger women?
- Diagnosing breast cancer in younger women (under 40 years old) is more difficult because their breast tissue is generally denser than the breast tissue in older women, and routine screening is not recommended.
- Breast cancer in younger women may be more aggressive and less likely to respond to treatment.
- Women who are diagnosed with breast cancer at a younger age are more likely to have genetic mutations predisposing them to breast and other cancers.
- Younger women who have breast cancer may ignore the warning signs—such as a breast lump or unusual discharge—because they believe they are too young to get breast cancer. This can lead to a delay in diagnosis and poorer outcomes.
- Some healthcare providers may also dismiss breast lumps or other symptoms in young women or adopt a "wait and see" approach.
- Breast cancer poses additional challenges for younger women as it can involve issues concerning sexuality, fertility, and pregnancy after breast cancer treatment.
Can breast cancer in younger women be prevented?
For women with a family history that is suggestive of a hereditary predisposition for breast cancer, a referral for genetic counseling may be appropriate. Identifying such genetic conditions will allow for a more personalized discussion on screening and preventive treatment options. For example, screening in BRCA mutation carriers begins at the age of 25.
Measures that all women can take to reduce breast cancer risk include:
- Achieving and maintaining ideal body weight
- Limiting alcohol consumption
- Getting regular exercise
That being said, if breast cancer does develop, early detection and prompt treatment can significantly increase a woman's chances of survival. More than 90% of women whose breast cancer is found in an early stage will survive.
Young women should be counseled on breast awareness and to report any breast changes to their healthcare provider. These changes can include:
- Nipple discharge
- Focal pain
- Skin changes
Should women under age 40 get mammograms?
In general, screening mammograms are not recommended for women under 40 years old. However, for women with genetic mutations, screening can begin at 25, and in women with a family history of breast cancer, screening is often initiated 10 years earlier than the first affected relative in the family. Breast MRI is often recommended to high risk women in addition to mammography.
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