Breast Cancer In Young Women: What To Consider?

Early detection through mammography and regular breast self-examination is essential for early diagnosis and increased survival rates.

The World Health Organization has estimated an incidence of 2.30 million cases of breast cancer in 2022, and 3.36 million by 2045.

It is a highly heterogeneous disease: it is composed of different subtypes, each of which presents a characteristic biological and molecular profile. This requires personalized treatment and an increasingly precise oncological approach.

But is its onset a matter of age? Traditionally, it has been considered to primarily affect older women. Its incidence has increased over the past few decades due to the aging of the population.

However, the scientific community has observed that breast cancer in patients under 40 has been on the rise in recent years. In 2019, the percentage of cases in the United States affecting this population was around 4 percent, while more recent systematic reviews put the overall incidence at between 5 and 7 percent, varying depending on the country’s development and ethnicity.

Although age is indeed one of the non-modifiable risk factors, along with sex (being female), early menarche (first menstruation), and late menopause, women with breast cancer under the age of 40 form a subgroup of patients with specific clinical management and psychosocial, fertility, and social-labor reintegration conditions.

Risk factors in women under 40 years of age

There is no single risk factor that increases the likelihood of developing this disease, but rather a combination of variables. According to the World Health Organization, exposure to exogenous and modifiable factors such as overweight and obesity, tobacco, alcohol, pollution, and a sedentary lifestyle is associated with some types of cancer, such as colorectal cancer and the one we are discussing here, breast cancer.

Other factors that may explain the increase in incidence among the younger population are reproductive: nulliparity (not having children or not having carried any pregnancy to term), late age at first birth and, in general, the delay in motherhood in today’s society increase the risk, although they cannot be considered direct causal agents.

Among the non-modifiable factors, the onset of the disease in young women may be due to a genetic predisposition, particularly mutations in the BRCA 1 and 2 genes. If a hereditary syndrome is suspected, specialists at genetic counseling units provide recommendations and preventive measures for healthy carriers.

Furthermore, women under 40 can develop pregnancy-associated breast cancer during pregnancy and breastfeeding, or within one year of giving birth. Despite the normal physiological changes in the breast during pregnancy, it is important to detect abnormalities that may lead to consultation with specialists. In any case, breastfeeding is also considered a protective factor.

Finally, a circumstance that can further increase the risk is having received chest radiation therapy between the ages of 10 and 30 to treat another type of cancer.

The importance of early diagnosis and prevention

Overall, early diagnosis of breast cancer through screening programs and increasingly precise and targeted treatments with a multidisciplinary approach have led to this disease having good survival rates: over 90% in low-risk tumor profiles.

These early detection programs are carried out through mammography and usually begin between the ages of 45 and 50.

Furthermore, women should perform a breast self-examination every month throughout their lives. Knowing their breasts well will allow them to detect changes and identify abnormalities (lumps, changes in color, skin retraction, discharge, etc.) that may warrant consultation with a specialist.

As for prevention, and as we noted above, avoiding excess body weight, not smoking, not drinking alcohol, and exercising regularly reduces the risk of suffering from this disease.

But it’s not enough. Hospital breast units work daily not only to diagnose and treat the disease, but also to improve the quality of life of patients who overcome it, promoting a healthy lifestyle before, during, and after diagnosis, as well as an appropriate psychosocial approach.