Breast Cancer Res Treat. 2018 Jun;169(3):595-606. doi: 10.1007/s10549-018-4699-9. Epub 2018 Feb 14.

Differences in breast cancer incidence among young women aged 20-49 years by stage and tumor characteristics, age, race, and ethnicity, 2004-2013.

Shoemaker ML¹, White MC², Wu M², Weir HK², Romieu I^3,^4,⁵.

Author information

1: Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Bldg. 107, F-76, 4770 Buford Highway, NE, Atlanta, GA, 30341, USA. mxw5@cdc.gov.
2: Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Bldg. 107, F-76, 4770 Buford Highway, NE, Atlanta, GA, 30341, USA.
3: Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.
4: Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico.
5: Hubert Department of Global Health, Emory University, Atlanta, GA, USA.

Abstract

PURPOSE:

Younger women diagnosed with breast cancer have poorer prognoses and higher mortality compared to older women. Young black women have higher incidence rates of breast cancer and more aggressive subtypes than women of other races/ethnicities. In this study, we examined recent trends and variations in breast cancer incidence among young women in the United States.

METHODS:

Using 2004-2013 National Program of Cancer Registries and Surveillance, Epidemiology, and End Results Program data, we calculated breast cancer incidence rates and trends and examined variations in stage, grade, and tumor subtype by age and race/ethnicity among young women aged 20-49 years.

RESULTS:

The majority of breast cancer cases occurred in women aged 40-44 and 45-49 years (77.3%). Among women aged < 45 years, breast cancer incidence was highest among black women. Incidence trends increased from 2004 to 2013 for Asian or Pacific Islander (API) women and white women aged 20-34 years. Black, American Indian or Alaska Native, and Hispanic women had higher proportions of cases diagnosed at later stages than white and API women. Black women had a higher proportion of grade III-IV tumors than other racial/ethnic groups. Across all age groups, incidence rates for triple-negative breast cancer were significantly higher in black women than women of other races/ethnicities, and this disparity increased with age.

CONCLUSIONS:

Breast cancer among young women is a highly heterogeneous disease. Differences in tumor characteristics by age and race/ethnicity suggest opportunities for further research into personal and cultural factors that may influence breast cancer risk among younger women.