Key Takeaways
- Most cases of breast cancer occur in older adults, but about 9% of all new breast cancer cases in the United States occur in adults younger than 45 years old.
- Experts say the increased incidence of breast cancer in premenopausal women could be linked to factors like increased alcohol consumption, having fewer children, and having children later in life.
- Experts recommend that young adults start doing breast self-exams by age 20. Adults who are at high risk because of their family history, their genes, or other factors may want to consider getting breast cancer screenings like mammograms earlier.
In the United States, breast cancer is considered the most common cancer in women. It’s estimated that 1 in 8 women will get the disease in their life. Most cases of breast cancer occur in middle-aged and older women, but people under the age of 45 can also get it.
Not Just Women
Most research on breast cancer and other reproductive health conditions is done on people who are biologically female and identify as women. However, breast cancer does not exclusively occur in women.
Any person with breast tissue, regardless of their biological sex and gender identity, should talk to their provider about their cancer risk and learn about the preventive steps that are recommended.
According to the Centers for Disease Control and Prevention (CDC), about 9% of all new breast cancer cases in the United States occur in women under the age of 45. That means over 25,000 American women younger than 45 years old are diagnosed with breast cancer each year.
It might not sound like a lot of people, but that doesn't mean the statistic should be minimized.
Jack Jacoub, MD, a board-certified medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Medical Center, told Verywell that the number is significant enough to put cancer on the radar of younger women.
“[Young adults] should be aware of breast cancer under the age of 45 and be discussing it with their gynecologist and their primary care doctors during their women’s health visits,” Jacoub said.
Even if the number seems small right now, it may not stay that way. Constance Chen, MD, FACS, a board-certified plastic surgeon and breast reconstruction specialist, told Verywell that while the number of cases of breast cancer in younger adults is low compared to in other age groups, there is an increased incidence of breast cancer in premenopausal women.
In part, Chen said that rising cases of breast cancer in young people could be related to factors like “increased alcohol consumption or having fewer children and having children later in life, which can affect hormones and breast cancer incidence.”
If you’re a young adult who is concerned about your breast cancer risk and wondering what you can do, here’s what experts want you to know.
Know the Risk Factors
It might be more common in older adults, but breast cancer can affect people of any age. That’s why it’s never too early to learn about your risk factors.
While some breast cancer risk factors are lifestyle-related and may come on later in life, there are other risk factors, like your genes, that you’re born with.
“Breast cancer in younger women is often hereditary, said Chen. “And if not hereditary, then it may be unexpected.”
The diagnosis doesn’t just catch patients off-guard—providers can miss it, too.
“Unfortunately, breast cancer in younger women is often diagnosed at a later stage,” said Chen. “And it is also usually more aggressive and more difficult to treat.”
Chen and Jacoub shared that if you’re under the age of 45, you may have a higher risk for breast cancer if you:
- Have a personal history of breast cancer
- Have a strong family history of breast cancer or relatives who were diagnosed with breast cancer before the age of 45
- Have changes in certain breast cancer genes or genetic mutations known to increase the risk of breast cancer, such as the BRCA, CHEK-2, and PALB genes
- Have a first-degree relative (e.g., parent, sibling, or child) with a genetic mutation
- Have other breast health problems such as ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia
- Received radiation therapy to the breast or chest during childhood or early adulthood
- Have been told they have dense breasts on a mammogram examination
- Have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or has a first-degree relative with one of these syndromes
Find Out When to Get a Mammogram
Screening for breast cancer can help catch it early and when it’s more likely to be treatable. A mammogram exam is an X-ray picture of the breast that providers use to detect and diagnose breast diseases like cancer.
Mammograms are typically recommended every year for women between the ages of 45 to 54 and every two years for women who are 55 and older, according to the American Cancer Society.
However, Chen said that adults who fall outside of that age group but have a high risk for breast cancer should get a mammogram and a breast MRI sooner—typically starting at age 30.
In addition, Chen said that a woman with a strong family history of breast cancer should start screening for breast cancer 10 years before the age at which their family member was first diagnosed.
For example, if a woman’s mother was diagnosed with breast cancer at 40, then she should have her first mammogram at 30.
Chen also recommends that women who are at high risk for breast cancer—either because of family history, a genetic predisposition, or other factors—should alternate mammograms with a breast MRI screening (a test that uses radio waves and strong magnets to make detailed pictures of the inside of the breast).
“Women with a lifetime risk factor of 20% to 25% or greater are considered to be at a high risk of breast cancer and may need to start screening for breast cancer with mammograms and/or MRIs at age 30,” said Chen.
According to Chen, the screenings should continue as long as a woman is in good health and is expected to live 10 more years or longer.
If you are under the age of 45 and don’t know if you should get a mammogram or don’t understand your risk for breast cancer, ask your provider. They can guide you on when to start and how often to get screened.
Learn About Prevention
Beyond getting a mammogram, experts say there are other preventative measures you can take that may reduce your risk of breast cancer as a young adult.
Chen said young adults can perform self-breast examinations starting by age 20 and continue to practice every month throughout their lives, including during pregnancy and after menopause.
There are three ways to do a breast self-exam: circular, vertical, and wedge. Chen said that each method involves using the pads of the fingers to check the entire breast, including the underarms and upper chest.
“It is helpful to look at the breasts in the mirror to check for any visual changes. You are looking for lumps, puckering, dimpling, or any changes in breast size, shape, or symmetry since your last breast self-exam,” said Chen. “You should also check to see if your nipples are turned in or inverted.”
Jacoub added that not all lumps or changes discovered in self-exams are signs of breast cancer— however, if you wait a few weeks and notice new changes, you should contact your provider.
Other preventative measures the CDC recommends include:
What This Means For You
Breast cancer most often occurs in older adults, but people under age 45 should know their risk and talk to their providers about prevention.
Young adults should start doing self-breast examinations at age 20 and continue to do them every month for life.
People at high risk of breast cancer should get a mammogram at age 30 or earlier, depending on the guidance from their provider.
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