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October 2015

Breast Cancer in Young Women: Rare Disease or Public Health Problem?

Author Affiliations
  • 1Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
  • 2Breast Care Center, University of Michigan Comprehensive Cancer Center, Ann Arbor
JAMA Oncol. 2015;1(7):877-878. doi:10.1001/jamaoncol.2015.2112

Increased recent attention in medicine, the media, and by the public in general has generated the perception that rates of breast cancer among young women have been increasing. Approximately 11% of the 230 000 new cases of invasive breast cancer diagnosed annually in the United States occur in women younger than 45 years, making breast cancer the most frequently diagnosed cancer in young adults.1 Furthermore, breast cancer is the leading cause of cancer-related deaths in this age group, with survival rates for women younger than 40 years at diagnosis lower than for older women with the disease.1 Increasing incidence of breast cancer in young women over the past 3 decades seems to be limited to cases of advanced breast cancer, with Surveillance, Epidemiology, and End Results data indicating that rates of early-stage breast cancer have not changed substantially in the youngest women (25-39 years) between 1976 and 2009.2 In contrast, the incidence of advanced breast cancer increased by approximately 2% each year.2 Because of the rarity of advanced breast cancer in this age group, the absolute increase—from 1.53 cases per 100 000 women in 1976 to 2.90 cases per 100 000 women in 2009—was only 1.37 additional cases per 100 000 women.2 In addition, whereas the overall rate of breast cancer in young women does not seem to be increasing, the number of women younger than 45 years in the United States has increased by more than 9 million between 1980 and 2010, translating into more young women “at risk” for developing breast cancer in absolute numbers. This age demographic is expected to continue to increase in the United States, with the population of women between the ages of 20 and 44 years projected to exceed 53 million by 2015.3

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