An analysis of records from seven outpatient centers in the New York region found that 20 to 24% of all breast cancers diagnosed over an 11-year span occurred in women between 18 and 49 years old. These findings are being presented at the annual meeting of the Radiological Society of North America (RSNA).
"This research shows that a significant proportion of cancers are diagnosed in women under 40, a group for whom there are no screening guidelines at this time," said Stamatia Destounis, M.D., radiologist Elizabeth Wende Breast Care (EWBC) in Rochester, New York. "Consideration must be given by physicians caring for women in this age group to performing risk assessment in order to identify those who may benefit from more intensive screening due to being higher risk."
Growing national data sets have been pointing toward an uptick in breast cancer among younger women, which has encouraged experts to reconsider recommended screening ages and how patients are evaluated for risk.
Current Screening Advice Leaves a Gap for Younger Patients
For women considered average risk, the U.S. Preventive Services Task Force recommends mammography every other year beginning at age 40 and continuing until age 74. The American Cancer Society recommends yearly mammograms starting at age 45, with screening optional for those aged 40 to 44. Women who are classified as high risk may be advised to receive a breast MRI and a mammogram each year beginning around age 30, but there are still no established guidelines for women younger than that.
How the Research Was Conducted
Dr. Destounis and EWBC research manager Andrea L. Arieno, B.S., reviewed breast cancer diagnoses made from 2014 through 2024 across seven outpatient facilities spread over a 200-mile area in Western New York. Their goal was to identify every case diagnosed in women aged 18 to 49 and gather detailed information from clinical imaging reports.
"We specifically collected details on how the cancer was found (screening or diagnostic), the type of cancer and other tumor characteristics," Dr. Destounis said. "We excluded cases that were not primary breast cancer. We analyzed trends over time by age subgroups, detection method and tumor biology. This helped us to identify how breast cancer presents in this patient population, how frequently it occurs and the types of tumors found."
Most Diagnosed Cancers Were Invasive and Often More Severe
The review identified 1,799 breast cancers in 1,290 women in the 18 to 49 age group. Each year, the number of cases ranged from 145 to 196. The average age at diagnosis was 42.6 years, with cases spanning from ages 23 to 49. Screening detected 731 cancers (41%), while diagnostic evaluation detected 1,068 (59%). Of the total, 1,451 cases (80.7%) were invasive, and 347 (19.3%) were non-invasive.
"Most of these cancers were invasive, meaning they could spread beyond the breast, and many were aggressive types -- especially in women under 40," Dr. Destounis said. "Some were 'triple-negative,' a form of breast cancer that is harder to treat because it doesn't respond to common hormone-based therapies."
Younger Women Consistently Account for One Quarter of Diagnoses
Although women under 50 made up only 21% to 25% of those screened each year, they still represented about one out of every four breast cancers detected annually.
"This is striking because it shows that younger women not only carry a stable and substantial share of the breast cancer burden, but their tumors are often biologically aggressive," she said. ""That combination, steady incidence plus disproportionately aggressive biology, directly challenges age-based screening cutoffs and strengthens the case for earlier, risk-tailored screening approaches."
Stable Numbers Suggest a Long-Term Concern
Dr. Destounis also pointed out that the number of diagnosed cancers in younger women remained consistently high throughout the study period. Even when fewer young women were seen overall, the absolute number of cancers did not decline.
"That means this problem is not going away," she said. "It is here to stay and needs to be addressed on a larger scale. Research such as this supports earlier and tailored screening to allow for earlier detection and better treatment outcomes. This data reinforces that women under 50, especially those under 40, shouldn't be seen as 'low risk' by default and can absolutely benefit from risk assessment being performed as early as possible."
Awareness and Risk Factors for Younger Women
Dr. Destounis advised that younger patients should be encouraged to monitor breast changes and begin screening in specific situations.
"Those with a strong family history or genetic mutation, as well as certain minorities and ethnic backgrounds, are at higher risk for breast cancer at a younger age," she said.
Age Alone Is Not Enough for Screening Decisions
She added that the study reinforces an important point: breast cancer in younger women is not uncommon, and cases in this group are often more serious.
"We can't rely only on age alone to decide who should be screened," she said. "Paying closer attention to personal and family history, and possibly screening earlier for some women, could help detect these cancers sooner."
An analysis of records from seven outpatient centers in the New York region found that 20 to 24% of all breast cancers diagnosed over an 11-year span occurred in women between 18 and 49 years old. These findings are being presented at the annual meeting of the Radiological Society of North America (RSNA).
"This research shows that a significant proportion of cancers are diagnosed in women under 40, a group for whom there are no screening guidelines at this time," said Stamatia Destounis, M.D., radiologist Elizabeth Wende Breast Care (EWBC) in Rochester, New York. "Consideration must be given by physicians caring for women in this age group to performing risk assessment in order to identify those who may benefit from more intensive screening due to being higher risk."
Growing national data sets have been pointing toward an uptick in breast cancer among younger women, which has encouraged experts to reconsider recommended screening ages and how patients are evaluated for risk.
Current Screening Advice Leaves a Gap for Younger Patients
For women considered average risk, the U.S. Preventive Services Task Force recommends mammography every other year beginning at age 40 and continuing until age 74. The American Cancer Society recommends yearly mammograms starting at age 45, with screening optional for those aged 40 to 44. Women who are classified as high risk may be advised to receive a breast MRI and a mammogram each year beginning around age 30, but there are still no established guidelines for women younger than that.
How the Research Was Conducted
Dr. Destounis and EWBC research manager Andrea L. Arieno, B.S., reviewed breast cancer diagnoses made from 2014 through 2024 across seven outpatient facilities spread over a 200-mile area in Western New York. Their goal was to identify every case diagnosed in women aged 18 to 49 and gather detailed information from clinical imaging reports.
"We specifically collected details on how the cancer was found (screening or diagnostic), the type of cancer and other tumor characteristics," Dr. Destounis said. "We excluded cases that were not primary breast cancer. We analyzed trends over time by age subgroups, detection method and tumor biology. This helped us to identify how breast cancer presents in this patient population, how frequently it occurs and the types of tumors found."
Most Diagnosed Cancers Were Invasive and Often More Severe
The review identified 1,799 breast cancers in 1,290 women in the 18 to 49 age group. Each year, the number of cases ranged from 145 to 196. The average age at diagnosis was 42.6 years, with cases spanning from ages 23 to 49. Screening detected 731 cancers (41%), while diagnostic evaluation detected 1,068 (59%). Of the total, 1,451 cases (80.7%) were invasive, and 347 (19.3%) were non-invasive.
"Most of these cancers were invasive, meaning they could spread beyond the breast, and many were aggressive types -- especially in women under 40," Dr. Destounis said. "Some were 'triple-negative,' a form of breast cancer that is harder to treat because it doesn't respond to common hormone-based therapies."
Younger Women Consistently Account for One Quarter of Diagnoses
Although women under 50 made up only 21% to 25% of those screened each year, they still represented about one out of every four breast cancers detected annually.
"This is striking because it shows that younger women not only carry a stable and substantial share of the breast cancer burden, but their tumors are often biologically aggressive," she said. ""That combination, steady incidence plus disproportionately aggressive biology, directly challenges age-based screening cutoffs and strengthens the case for earlier, risk-tailored screening approaches."
Stable Numbers Suggest a Long-Term Concern
Dr. Destounis also pointed out that the number of diagnosed cancers in younger women remained consistently high throughout the study period. Even when fewer young women were seen overall, the absolute number of cancers did not decline.
"That means this problem is not going away," she said. "It is here to stay and needs to be addressed on a larger scale. Research such as this supports earlier and tailored screening to allow for earlier detection and better treatment outcomes. This data reinforces that women under 50, especially those under 40, shouldn't be seen as 'low risk' by default and can absolutely benefit from risk assessment being performed as early as possible."
Awareness and Risk Factors for Younger Women
Dr. Destounis advised that younger patients should be encouraged to monitor breast changes and begin screening in specific situations.
"Those with a strong family history or genetic mutation, as well as certain minorities and ethnic backgrounds, are at higher risk for breast cancer at a younger age," she said.
Age Alone Is Not Enough for Screening Decisions
She added that the study reinforces an important point: breast cancer in younger women is not uncommon, and cases in this group are often more serious.
"We can't rely only on age alone to decide who should be screened," she said. "Paying closer attention to personal and family history, and possibly screening earlier for some women, could help detect these cancers sooner."
Read more https://www.sciencedaily.com/releases/2025/12/251201233536.htm