Breast Cancer Under 40, Know Your Risk Factors

October 11, 2018

Breast cancer is rare in younger women. Fewer than five percent of all breast cancers diagnosed in the U.S. occur in women under 40.1 Even so, if you are a woman in your 20s or 30s, you may worry about your risk of breast cancer now and in the future.

In general, the risk of breast cancer is low for younger women. For women 40 or younger, the chance of developing breast cancer over the next 10 years is less than two percent.

Most factors that increase breast cancer risk in older women (such as drinking alcohol) also increase risk in younger women. And, most factors that lower risk in older women (such as ever having breastfed) also lower risk in younger women.

We don’t know what causes breast cancer to develop in any one woman, no matter her age. However, a few factors are especially important to breast cancer risk in younger women. These include inherited gene mutations and African American ethnicity.

Certain genetic factors put younger women at an increased risk of breast cancer. BRCA1 and BRCA2 (BReast CAncer 1 and 2) are the best-known genes related to breast cancer risk. Women who have an inherited mutation in one of these genes have an increased risk of both breast and ovarian cancers.

Breast cancers related to BRCA1 and BRCA2 mutations tend to develop at a younger age than other breast cancers. For this reason, younger women diagnosed with breast cancer may be recommended for genetic testing for BRCA1 and BRCA2 mutations.2 However, it is important to remember that most breast cancers, even among younger women, are not caused by gene mutations.
Screening mammograms are not recommended for women younger than 40 who are at average risk of breast cancer. For most women ages 20 to 39, clinical breast exam at least every three years is recommended

However, for younger women at a higher risk of breast cancer (such as women with a BRCA1 or BRCA2 gene mutation) more intensive screening may be recommended. These women may begin mammography at an earlier age and they may need breast MRI in addition to mammography and clinical breast exams.2,10-11

Because most young women do not get mammograms, breast cancer is most often first detected when a woman notices a lump or change in the look or feel of her breast, nipple or underarm area. A health care provider may also note a change during a clinical breast exam.

Although most changes in a young woman’s breast are not breast cancer, any change should be reported to a health care provider.

In women under 40, breast cancer is not common, but it does occur. Although we don’t know all the risk factors for breast cancer in younger women, having a BRCA1 or BRCA2 gene mutation greatly increases risk. Younger African American women also appear to have an increased risk compared to older African American women and younger women of other ethnicities.

Breast cancers that develop in younger women tend to be more aggressive than those in older women. However, with treatment, prognosis tends to be good and most younger breast cancer survivors go on to live full lives.

While a breast cancer diagnosis is a shock for any woman, younger women face special challenges. Treatment can cause early menopause and impact childbearing. For women who want to have a child after treatment, it is best to talk with a fertility specialist before treatment begins to have the widest range of options.

For younger breast cancer survivors, support may be especially important. Because so few younger women are diagnosed, it’s natural to feel alone. Although there are few support groups specific to younger women with breast cancer, there are support groups for younger women with any type of cancer. Online and phone sources of support are also available.



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