5 Takeaways from BCRF’s Webinar on Breast Cancer in Younger Women

BCRF’s Women’s Health Week webinar tackled trends, new research, and more

To kick off Women’s Health Week earlier this this week, BCRF hosted a critical conversation about the alarming rise of breast cancer in younger women—and the groundbreaking research that’s changing this trajectory.

BCRF investigators Drs. Virginia Borges and Lola Fayanju joined Dr. Diana Schlamadinger from BCRF’s Research team in a conversation Sadia Zapp, who was diagnosed with breast cancer at 36. Dr. Borges is the director of the Breast Cancer Research Program and the Young Women’s Breast Cancer Translational Program at University of Colorado Comprehensive Cancer Center, and Dr. Fayanju is chief of the Division of Breast Surgery at Penn Medicine.

Here, we recap five of the top takeaways from BCRF’s “Emerging Research on Breast Cancer in Younger Women” webinar. Watch the full video above and sign up for our email list to learn about future events.

1. Diagnoses are rising—but mortality is declining.

While breast cancer incidence in younger women is low, the panel’s experts all pointed out that concerningly, diagnoses are on the rise. Between 2012–2022, the breast cancer incidence rate in women under 50 rose faster than that in women over 50, and currently, breast cancer is the leading cause of cancer death in women aged 20 to 49 in the U.S.

But there’s good news, too. Between 2010-2020, there was an overall 80 percent decline in deaths from breast cancer in women aged 20-49, according to a new study shared at AACR just last month.

“This means that treatments are working. The science is working,” Zapp said. “Rapid advances in research are having an immediate effect on outcomes. But it bears mentioning that we’re still at a critical inflection point, because as incidence rises most rapidly among younger women, there’s still no cure for metastatic breast cancer and life-threatening disparities persist. Still, these results serve as just undeniable evidence that research is the key, and it works.”

2. We need more research to understand what’s driving the rise in incidence.

Dr. Borges noted that there are several likely drivers behind the increase in diagnoses. Because of research, we know that the age a woman has her first child likely plays a role: the later the age, the higher the risk.

“We’ve known for a very long time that when they start having children, all women—no matter how young or old they are—face a period of time where they actually have an increased risk of breast cancer by virtue of having had that child,” she said. “For many decades now, women globally and in the U.S. have been delaying the age at which they are starting their families, and that increases the likelihood of getting diagnosed during that time frame. That’s likely contributing to why we are seeing more cases.”

We also know that younger women tend to be diagnosed with more aggressive forms of the disease, like triple-negative breast cancer, and that women of color—and Black women in particular—are more likely to be diagnosed under 50.

Still, Dr. Borges noted, we’re seeing more women get diagnosed before they would have ever had children and as early as in their 20s. Factors like environmental exposures, lifestyle changes, and more may be contributing—and there’s still a lot more to uncover.

“All of us were an egg in our mother when our mother was an embryo in our grandmother, and so there could be things that generationally, our older relatives were exposed to that aren’t impacting us in a direct way, but are impacting maybe how our genes are expressed and, in combination, that are predisposing us to getting cancers at a younger age,” she said.

3. Disparities persist among younger women.

“There is this inversion where with post-menopausal breast cancer, you’re more likely to see that among white women. But in pre-menopausal women, you’re more like to see that among Black women,” Dr. Fayanju said. “There are all these factors that make it more likely a Black woman will be diagnosed before they’ve begun regular screening and with a cancer that’s more biologically aggressive.”

Dr. Fayanju noted that addressing these disparities will take numerous changes, but top among them is improving risk assessment.

“One of the most important things that we are not doing for women of color is identifying who is at elevated risk for breast cancer,” she said. “The truth of the matter is that women of color are less to know if we have inherited a mutation that puts us at increased risk for breast cancer, or to know if we have other risk factors, including dense breasts, that might put us at increased risk. Even the risk calculators we have are likely doing an insufficient job at identifying black women and Latina women and Asian women because these calculators were largely developed with less diverse populations.”

4. Our understanding of postpartum breast cancer is evolving.

“We expect there will be about 18,000 cases of postpartum breast cancer per year [defined as a diagnosis within five years of childbirth],” Dr. Borges said. “That number is derived from looking at statistics that show about 36,000 women under the age of 45 will get diagnosed. We don’t really know why someone would end up getting a postpartum breast cancer, so it makes it hard to establish increased screening recommendations or increased awareness that is tailored to those at highest risk, we just know that our young mothers are at risk.”

Dr. Borges said that more attention is finally being paid to postpartum breast cancer, but researchers need more specific data about things like when in the postpartum period women were diagnosed. Still, she sees progress in the fact that more large clinical trials are collecting such data to identify differences and inform treatment.

5. Progress is being made.

Dr. Schlamadinger from BCRF’s Research team highlighted the incredible recent progress we’ve made against the disease in just the last few years—as evidenced by the decline in mortality in younger women.

“Thanks to research, we have more targeted therapies that are contributing to precision medicine than ever before. Over the last decade alone, there have been 17 new drugs for breast cancer,” she said. “Doctors have even more treatment tools for triple-negative breast cancer, including an immunotherapy and an antibody-drug conjugate. These are just a few of the advances in precision medicine that have contributed to improvements in outcomes for younger for younger women and researchers are working tirelessly to pursue others to continually improve outcomes.”