Late-Stage Breast Cancer Is Rising Among Younger Women

The decline in deaths from breast cancer among younger women has stalled. Consider having earlier mammograms if you are at risk. Here’s what you should know.

Death from breast cancer has been declining among older women for 30 years. That’s great news.

The sad news is that, among women under the age of 40, the decline stalled a decade ago, according to one study.

The steady decrease in breast cancer deaths among older women can be credited to both improved treatment and an increase in screening. The U.S. Preventive Services Task Force mammogram guidelines recommend women begin screening at age 50. Women between 40 and 49 should talk to their doctor about when they should start having mammograms.

Cancer can arrive earlier than 50. About 5 percent of all U.S. breast cancers happen to women under the age of 40. Among women ages 20 to 39, late-stage diagnoses have increased 4 percent a year since 2000. The later a cancer is diagnosed the lower the chances of survival. Breast cancer in younger women can be more aggressive and spread quickly.

Don’t put off your mammogram. About one in three women skipped a mammogram because of the COVID-19 pandemic, researchers reported in a fall 2020 study.

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I’m Under 45. Do I need a Mammogram?

If you think you have a lump, at any age, get a mammogram.

If your mother, sister, or grandmother has had breast cancer, talk to your doctor about when to begin screening. It depends in part on the age when your relative had her cancer. Let’s say your mother had cancer after 50, but you are obese, which increases your own risk. You might start having mammograms at 40.

If your mother had breast cancer at 40, you might start even younger. In younger women, who tend to have denser breasts (more breast tissue than fat tissue), an MRI will be more accurate than a mammogram, and it’s also safer. Tumors will not show up as well in mammograms in younger women who have denser breasts.

To get insurance coverage, you’ll need a doctor to recommend an MRI because of your higher risk. Also note that women with dense breasts are already at higher risk of breast cancer.

Women who are carriers of the BRCA genetic mutation, which increases breast cancer risk, were once advised to begin yearly mammograms between ages 25 to 30, but research suggests that those early mammograms would actually increase their chance of a breast cancer from the radiation in the mammogram.

Other risk factors

Having heart disease can accelerate breast cancer, one study found, and heart disease has become the leading cause of death among American women.

Obesity, for which rates have been increasing, is also a risk factor.

New science

New treatments and diagnostic tools are coming along fast.

For example, an inexpensive genomic analysis can predict a person’s health risk for a range of diseases, including breast cancer, heart disease, diabetes, and more. With breast cancer, the test can identify 10 times as many high-risk individuals as the older single gene tests did.

The Food and Drug Administration has approved several drugs to treat HER2-positive cancers, which account for about 20 percent of all breast cancers.

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