Breast Cancer Continues to Rise Among Younger Women, Study Finds

 Breast Cancer Continues to Rise Among Younger Women, Study Finds - The New York Times (nytimes.com)

Rates of breast cancer — the second leading cause of cancer deaths in U.S. women — climbed by 1 percent a year from 2012 to 2021, and even more sharply among women under age 50 and among Asian American/Pacific Islander women of all ages, according to an American Cancer Society report published on Tuesday.

The biennial report is among the most comprehensive and detailed studies of breast cancer occurrence over recent years. One in 50 U.S. women will develop invasive breast cancer by the age of 50, the authors said, based on National Cancer Institute calculations.

The sharpest increases in young adults by age during the decade were among women in their 20s, whose rate increased by about 2.2 percent a year, though their absolute risk remains very low, at about 6.5 per 100,000 women.

Among Asian American/Pacific Islander women, who historically also have had a low prevalence of the disease, rates increased by 2.7 percent a year among those under 50, and by 2.5 percent a year among older women.

Cancer is generally considered a disease of aging, and that hasn’t changed: The vast majority of breast cancer cases and deaths still occur among older women. But the new study is one of several documenting a troubling uptick in malignancies among younger Americans.

These so-called early-onset cancers pose special challenges. Striking in early adulthood or midlife, they tend to be aggressive yet are often missed because they are not expected, and routine screenings are aimed at older adults.

That has been changing somewhat. Earlier this year, the U.S. Preventive Services Task Force lowered the age for initiating mammography to 40 from 50, reversing an earlier decision to raise the screening age. The American Cancer Society recommends starting annual mammography screening at 45 for women at average risk, with the option of starting at 40.

Despite the rise in incidence, deaths from breast cancer have plunged, dropping by about 10 percent in the last decade and by 44 percent in the past three decades because of improved screening and treatments.

ImageA portrait of Dani Alderman, who sits on a gray couch in an apartment and rests her head and hands on the couch's back.

Dani Alderman, 31, in her apartment in Chelsea. She was diagnosed in May 2023 with breast cancer.Credit...Jackie Molloy for The New York Times

But the benefits have not accrued equally to all women, according to the report, which was published in CA: A Cancer Journal for Clinicians.

Survival rates did not change at all for Native American and Alaska Native women. Breast cancer continues to be the leading cause of cancer deaths among Black women, who have a 38 percent higher death rate than white women.

Black women are more frequently diagnosed with certain kinds of tumors that are more difficult to treat. A recent Mass General Brigham study found that Black women are also more likely than white women to die of all types of breast cancer, suggesting that other factors are playing roles, like delays in diagnosis and difficulty finding timely quality care.

“The bottom line is, we need to improve access to high-quality screening and high-quality treatment for all women of color, especially to Black and Native American women,” said Rebecca L. Siegel, an epidemiologist at the American Cancer Society and senior author of the report. “We need to expand that progress to all women.”

Some 310,720 new cases of invasive breast cancer will be diagnosed in U.S. women this year, including 13,180 cases in women under 40 and 37,650 in women in their 40s, the paper estimated. In addition, 56,500 cases of noninvasive ductal carcinoma in situ will be diagnosed in women of all ages.

An estimated 42,250 women will die of breast cancer, according to the study. Some 2,790 cases will be diagnosed in men, and 530 will die of it.

Breast cancer incidence rose by 1 percent a year overall from 2012 to 2021. But women in their 20s, 30s and 40s experienced a 1.4 percent annual increase in incidence, while the increase among women 50 and older was more moderate, at 0.7 percent each year, the report found.

Getting a diagnosis often takes longer in younger women, leading to delays in treatment and more advanced disease.