Leading Breast Radiologists Discuss Rise of Breast Cancer Incidence in Women Under 40

Is breast cancer incidence rising among women under the age of 40?

Recent research demonstrated a 7 percent increase of invasive breast cancer between 2004 and 2017 for women under 40 years of age.^1,2 Another study, published in 2024, found over a three percent annual increase in breast cancer incidence since 2001 for women between 20 to 29 years of age and a 1.25 percent annual increase from 2009 for women 30 to 39 years of age.³

“We're seeing this every day in practice. You know, it's not uncommon for me to diagnose a breast cancer in a woman who is 26 whereas 20 years ago, we almost never saw this. It was very rare,” said Jean Seely, M.D., the lead author of the aforementioned 2024 study, a professor in the Department of Radiology at Ottawa University and head of the Breast Imaging Section in the Department of Medical Imaging at Ottawa Hospital.

Given this emerging trend, Zeeshan Shah, M.D., said there needs to be mindset change for radiologists as well as referring care providers away from the notion that breast cancer is limited to older patient populations.

“We've set up everything that we do to really kind of guide an older patient population. You know, we still stand by that mantra, start at 40 and screen every year from there on, based on what the (American College of Radiology) ACR and the Society of Breast Imaging says, but certainly, we have seen that younger population kind of come in with breast cancers that are unexpected,” noted Dr. Shah, the president of Elite Breast Imaging. “ … We are seeing cancers earlier. The incidence is increasing so you do have to have a little bit more vigilance about it.”

Amy Patel, M.D., concurred about the emerging trend of breast cancer incidence in younger women. While noting that the proposed Find It Early Act legislation may provide coverage for women under 40 with a high risk of breast cancer, Dr. Patel called for more research to address potential gaps in screening for younger women with average to intermediate risk.

“There's just still research to be done, particularly in those populations with your average to intermediate risk and younger than the age of 40. We really need to explore research and then see what we can do to support those patients to make sure that they receive the access to care that they need appropriately,” maintained Dr. Patel, the medical director of the Liberty Hospital Breast Care Center in Kansas City.

(Editor’s note: For related content, see “Can Contrast-Enhanced Mammography be a Viable Screening Alternative to Breast MRI?,” “Do the New USPSTF Recommendations Go Far Enough on Mammography Screening?” and “A Closer look at the Impact of Expanded Mammography Coverage in Missouri: An Interview with Amy Patel, MD.”)

For more insights from Drs. Patel, Seely and Shah, watch the video below.

References

1. Kehm RD, Yang W, Tehranifar P, Terry MB, 40 years of change in age- and stage-specific cancer incidence rates in US women and men. JNCI Cancer Spectr. 2019;10(3):pkz038. Doi: 10.1093.jncics/pkz038. eCollection 2019 Sep.

2. Acheampong T, Kehm RD, Terry MB, Argov EL, Tehranifar P. Incidence trends of breast cancer molecular subtypes by age and race/ethnicity in the US from 2010 to 2016. JAMA Netw Open. 2020 Aug 3;3(8):e2013226.

3. Seely JM, Ellison LF, Billette JM, Zhang SX, Wilkinson AN. Incidence of breast cancer in younger women: a Canadian trend analysis. Can Assoc Radiol J. 2024;75(4):847-854.