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Breast cancer in young women

Nature Reviews Clinical Oncology volume 9, pages 460–470 (2012)Cite this article

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Abstract

About one in 300 women will be diagnosed with breast cancer before the age of 40. Advances in screening have not had an impact on mortality in women who are too young to be candidates for screening. Risk factors for early breast cancer include a lean body habitus and recent use of an oral contraceptive. Breast cancers in very young women are typically aggressive, in part owing to the over-representation of high-grade, triple-negative tumours, but young age is an independent negative predictor of cancer-specific survival. Very early age-of-onset also correlates strongly with the risk of local recurrence and with the odds of contralateral breast cancer. Given the high risks of local and distant recurrence in young women with invasive breast cancer, most (if not all) young patients are candidates for chemotherapy. It is hoped that by increasing breast cancer awareness, the proportion of invasive breast cancers that are diagnosed at 2.0 cm or smaller will increase and that this will lead to a reduction in mortality.

Key Points

  • Rates of very early onset breast cancer have been stable in recent years

  • Early onset breast cancer is not clearly related to westernization or standard of living

  • Young age is an independent risk factor for survival

  • Rates of ipsilateral recurrence and contralateral breast cancer are high in young women

  • Cancer control in young women should focus on breast cancer awareness

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Figure 1: Trends in cumulative risk of breast cancer by continent; age <40 years.1
Figure 2: Cumulative risk of breast cancer by total fertility rate, age at menarche and per capita income.1,9
Figure 3
Figure 4

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    Steven A. Narod

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Narod, S. Breast cancer in young women. Nat Rev Clin Oncol 9, 460–470 (2012). https://doi.org/10.1038/nrclinonc.2012.102

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