SMART NEWS

Breast Cancer Cases Are Rising Among Younger Women, Report Finds

Though breast cancer mortality is declining overall, Asian American women and women under 50 have experienced an uptick in diagnoses of the disease

Shi En Kim

Reporter

a nurse explains how to use a mammography machine to a patient
Annual mammograms are recommended for women in their 40s and above, but new research suggests younger adults are increasingly at risk for breast cancer. izusek via Getty Images

At only 34 years of age, Traci Delaney seemed to be an unlikely candidate for developing breast cancer. As she tells Roni Caryn Rabin of the New York Times, even her insurance declined to cover an imaging scan that her doctor ordered, despite the fact that she’d felt a hard mass in her right breast. At first, she wasn’t worried, but further tests concluded she had Stage II breast cancer.

The Los Angeles resident is now in remission after going through treatment last year. “The biggest thing I realized during this whole entire process is that there’s no age limit on this,” she tells the newspaper.

Delaney is one of many women who are part of a trend of soaring breast cancer cases among the younger demographic in the United States. While the overall mortality rate for breast cancer has declined by 44 percent between 1989 and 2022, a new report published Tuesday by the American Cancer Society finds that breast cancer incidence crept upward by 1 percent each year between 2012 and 2021.

Among the new diagnoses, women younger than 50 are experiencing a sharper uptick than their older counterparts, contrary to the disease typically being associated with older age.

“That is very alarming,” Sonya Reid, an oncologist at Vanderbilt University Medical Center who was not involved with the report, tells NBC News’ Kaitlin Sullivan. “It’s not just one racial or ethnic group affected; we are seeing it across the board.”

First, the good news: The overall decline in mortality rate is thanks to advancements in treatment and earlier detection through mammograms. Still, breast cancer remains the second most common cancer among women in the U.S. and is the second leading cause of cancer death, behind skin cancer and lung cancer, respectively. The American Cancer Society recommends that women 45 years and older get yearly mammograms so as to detect breast cancer early.

However, the new report suggests that guideline isn’t perfect, for the recommendation might be overlooking the hordes of younger women among whom the incidence of breast cancer is on the rise. Moreover, cancer among younger women tends to be more aggressive—but this age group often takes longer to receive a diagnosis and thus start treatment, according to the New York Times.

It’s challenging to pinpoint the reasons for the upward trend of breast cancer numbers. One potential explanation is increased screening among the general population, allowing for more cases to be detected. As such, experts have long debated when screening should begin, because more mammograms might increase false positives and raise patient anxiety over benign lumps. The U.S. Preventive Services Task Force has flip-flopped on the issue over the last few decades: In 2009, the organization withdrew its recommendation for routine screening for women in their 40s, only to reinstate its support earlier this year. But experts say this new report emphasizes the importance of early screening.

Risk factors that may contribute to the rise in early breast cancer diagnoses are more difficult to parse. Breast cancer is associated with family history and lifestyle choices such as alcohol intake and physical inactivity. Environmental exposure to chemicals—such as those in food packaging and personal care products—might also play a role, though it’s unclear how much it contributes to the overall breast cancer statistics.

Chances are, the trend doesn’t have one single cause. “There are all sorts of ideas we can throw out as to the reasons why, but until it’s studied, we won’t know for sure,” Wendy Wilcox, the chief women’s health officer at New York City Health + Hospitals, tells NBC News.

Troublingly, the report illuminates racial disparities among breast cancer patients. Young Asian American and Pacific Islander women saw the greatest annual increase in breast cancer incidence compared with any other demographic, at 2.5 percent. Among this group, diagnoses of breast cancer have risen by 50 percent since 2000.

Increased breast cancer survival also hasn’t translated uniformly to all racial groups. Per the new report, the mortality rate has stagnated among American Indian and Native Alaskan women since 1990. Additionally, Black women experience the lowest survival rates from most kinds of breast cancer, with a 35 percent higher mortality rate than white women despite a lower incidence of the disease. Although Black women are more frequently diagnosed with a hard-to-treat type of cancer known as triple negative breast cancer compared to white women, their mortality rate is still disproportionately higher.

Breast cancer is the leading cause of cancer death among Black and Hispanic women—not the second, as it is with other racial groups. This reflects that social factors and unequal access to care determine cancer outcomes among various demographic groups.

“Black women are more likely to receive mammograms at lower-quality facilities, face delays in diagnosing abnormalities and experience delays in starting and completing treatment,” study co-author Lisa Newman, breast surgery section chief at NewYork-Presbyterian/Weill Cornell Medical Center, tells ABC News.

“Moving forward, we really need to make sure we have wide access to effective treatments for all of our patients,” Reid tells NBC News.

No matter what the risk factors predict, and whether or not people try their best to live healthy lives, a breast cancer diagnosis still comes as a shock to the recipient.

New York City resident Dani Alderman found out that she had breast cancer a week before her 30th birthday. Though she carries a genetic signature that raises her breast cancer risk, even her doctors informed her that she had little chance of developing it, given her age, she tells the New York Times. “I have the gene, but something makes the gene express itself,” she says to the publication. “I exercise five days a week, I don’t really drink alcohol, and I eat healthy. Is it the microplastics? The processed food?”

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Shi En Kim

Shi En Kim is a Washington, D.C.-based freelance science journalist. Her work has appeared in National Geographic, Scientific American, the Atlantic, Popular Science and others. In 2021, she interned at Smithsonian magazine as an AAAS Mass Media Fellow.