Early-Onset Breast Cancer (Breast Cancer in Young Women)

What is early-onset breast cancer?

Breast cancer in young women and people assigned female at birth (AFAB)— also known as early-onset breast cancer — is when you receive a breast cancer diagnosis between the ages of 18 and 45.

Breast cancer can strike at any age, though most people are over 50 when they receive a diagnosis. But you can be diagnosed while you’re younger, too. Even adolescents and young adults can get breast cancer.

What is different about breast cancer in young women?

When a young person receives a breast cancer diagnosis, their disease may be more advanced than if they were over 45. One reason for this may be that breast cancer in this age group might be more advanced when it’s found, as routine screenings for breast cancer don’t usually start until age 40. Additionally, young people might not recognize symptoms and alert their healthcare provider.

Breast cancers in people under 45 may also be aggressive and harder to treat based on tumor markers.

What types of breast cancer can young women get?

Young people can get any type of breast cancer. That said, the most common breast cancers in young people are:

• Invasive ductal carcinoma. This is the most common breast cancer at any age.
• Triple-negative breast cancer. This rare form of invasive breast cancer can be more difficult to treat.

How common is breast cancer in young women?

Breast cancer is less common in young people than in people over 45, but it’s not rare. Between the years 2012 and 2016, about 10% of new female breast cancer diagnoses were early-onset breast cancer

In the United States, data on adolescents and young adults (between the ages of 15 and 39) indicate that about 1 in 196 women are diagnosed with invasive breast cancer.

What are symptoms of breast cancer in young women?

Breast cancer symptoms in young women are the same as other people with breast cancer. Symptoms may include:

• Breast lumps or a lump in your armpit.
• Breast pain (mastalgia).
• Changes in the skin of your breast, like redness, dimpling or skin rash.
• Inverted nipple.
• Nipple discharge, with or without nipple pain.
• Swollen lymph nodes.
• Thickening or swelling in your breast skin or nipple.

What causes breast cancer at a young age?

About half of early-onset breast cancers are related to mutations in BRCA1 or BRCA2 genes (genetic mutations). If they’re not mutated, these tumor suppressor genes work like a switch to control (turn off) the growth of abnormal cells that might cause cancer. If they’re mutated, the abnormal cells multiply unchecked. If you have a mutation in BRCA1 or BRCA2, you may be at higher risk for breast and ovarian cancer.

Researchers are looking for other genetic mutations that might increase your risk of early-onset breast cancer. Your risk is higher if you have mutations on genes like TP53, PTEN, STK11, PALB2 and CDH1. There are others as well, and we expect research to identify more relationships in the coming years.

It’s important to note that not all early-onset breast cancer is genetic. Some breast cancers occur on their own (spontaneously).

What are the risk factors?

Your family’s medical history plays a big role in your risk of developing breast cancer while you’re young. You’re at higher risk if you have family members who had or have:

• Breast cancer before age 50.
• Cancer in both breasts.
• Male breast cancer.
• Metastatic prostate cancer.
• Ovarian cancer at any age.
• Pancreatic cancer.
• Triple-negative breast cancer.

Other risk factors include:

• Gene mutations, like as BRCA1 and BRCA2, or a family member who has or had these mutations.
• Previous radiation therapy to your chest.
• Precancerous breast conditions, like atypical hyperplasia or lobular carcinoma in situ (LCIS).
• If you’re of Ashkenazi Jewish descent.

If you have a family history of breast cancer, your healthcare provider may recommend genetic testing. This blood test helps your provider determine if you have a mutation that increases your risk for breast or other cancer. If you have a mutation, your provider may recommend genetic counseling to help you understand your risk. In addition, you may benefit from being linked to a high-risk breast clinic for risk management and follow-up.

How is breast cancer diagnosed in young women?

Your age doesn’t change the way healthcare providers diagnose breast cancer. Your healthcare provider will first perform a breast exam. Next, they’ll ask about your symptoms, personal history and family history. They may also order imaging to look for abnormal growths in your breast. If something doesn’t look right, your healthcare provider might take a biopsy of your breast tissue.

What are the types of breast cancer screening in young women?

If you’re under 40 and at increased risk of breast cancer, your healthcare provider may recommend:

• Breast MRI.
• Frequent mammograms.

Should women under age 40 get mammograms?

In general, screening mammograms aren’t recommended for people under 40 years. But if you have a known genetic mutation or relatives who had breast cancer when they were young, your healthcare provider may recommend screening earlier. If they do recommend extra screenings, try not to worry.

If you do develop breast cancer, they’ll be more likely to catch it earlier when it hasn’t had time to spread (metastasize) to other organs and is most responsive to treatment.

How do healthcare providers treat breast cancer in young women?

Treatment begins with a conversation between you and your healthcare provider about your breast cancer type and cancer stage. They’ll also ask if you have any desire to build a family. Together, you and your provider will develop a treatment plan that’s right for you.

Depending on your specific case and tumor markers, your treatment plan may include:

• Breast cancer surgery, such as lumpectomy or mastectomy (breast removal).
• Chemotherapy.
• Hormone therapy.
• Immunotherapy treatment.
• Radiation therapy.
• Targeted therapy.

What are the complications of treatment?

Undergoing chemotherapy or radiation therapy may affect your ability to have a healthy pregnancy. If you’re interested in having a family or adding to it, it’s important to talk to your healthcare provider about fertility preservation options before you begin breast cancer treatment.

If you receive estrogen blockers as part of hormone therapy, you may also experience symptoms of menopause.

You may have other side effects from your breast cancer treatment, too, like:

• Anxiety or depression.
• Body image concerns.
• Cancer fatigue.
• Cancer pain.
• Lymphedema.

Can I lower my risk of getting breast cancer at a young age?

There’s no way to prevent breast cancer from developing at any age. But if you’re found to have a high risk for breast cancer, get earlier and more frequent breast screenings. Your provider may also recommend genetic counseling.

If you notice a lump in your breast or any breast pain or breast changes, see a provider. Early diagnosis gives you the best chance for successful treatment.

What are my options if I’m at high risk for developing breast cancer?

If you have a gene mutation and are at high risk for breast cancer, talk to your healthcare provider. They’ll discuss your particular risk factors and develop a screening schedule. In some cases, they may recommend considering a prophylactic (preventive) mastectomy.

What is the survival rate in young women with breast cancer?

When it comes to breast cancer, survival is more about the type and stage of cancer than your age.

The relative five-year survival rate for women with invasive breast cancer that hasn’t spread (metastasized) is 91%. This means that most people diagnosed at this stage are alive five years after diagnosis.

If the cancer spreads beyond your breast — to lymph nodes or other organs — survival rates decrease. The five-year survival rate for breast cancer that’s spread to lymph nodes is 86%.

If it spreads to a distant part of your body, like your bones, liver, lungs or brain, the five-year survival rate is 31%.

As everyone’s situation is different, it’s best to ask your oncologist about your cancer type and stage and what you can expect in the years to come.

How do I take care of myself?

Finding out that you have cancer is probably one of the toughest things you’ve ever faced. There are strong emotions, challenging conversations and a ton of appointments to schedule. You’ll have rough days — both physically and emotionally. But having the right support can help.

Your healthcare provider can connect you with support groups, provide information about cancer survivorship and offer recommendations that they’ve seen help other young people with breast cancer.

How young can you get breast cancer?

You can get breast cancer at any age, including when you’re an adolescent or young adult (although this is rare). About 10% of new breast cancer diagnoses are people under 45.