There is a significant “drop” in the age of new breast cancer diagnoses, raising concerns about the effectiveness of prevention since patients are often so young that they have not even been included in screening programs. Experts emphasize that the problem lies not only in age but also in the aggressiveness of these new cases.

According to research presented at the annual meeting of the Radiological Society of North America (RSNA), women under 50 represent a stable and significant proportion of breast cancer diagnoses, with many of these tumors being invasive and difficult to treat.

A similar picture emerges from an 11-year analysis of patient records from 7 centers in New York, which found that 20-24% of all breast cancer cases involve women aged 18-49, with an average diagnosis age of 42.6 years. Mammograms detected 41% of cancers, while the remaining 59% were discovered after diagnostic evaluation of patients’ symptoms. Even more worrying is that a large proportion of breast cancers in women under 40 were particularly aggressive, including triple-negative breast cancer—a type that does not respond to most hormonal therapies. More specifically, about 81% of tumors were invasive, meaning they had the potential to metastasize.

“A significant percentage of cancers are diagnosed in women under 40, a population group for which there are currently no preventive screening guidelines,” said Dr. Stamatia Destouni, a radiologist at Elizabeth Wende Breast Care. “Doctors monitoring young women should assess the risk of each individual to identify those who need earlier preventive screening,” she added.

The “Gap” in Prevention Poses a Risk for Young Women

Current recommendations for breast cancer screening primarily focus on women over 40. The U.S. Preventive Services Task Force recommends mammography every 2 years starting at age 40, while the American Cancer Society suggests annual screening from age 45, with optional screening between 40 and 44. High-risk women, such as those with BRCA1 or BRCA2 genetic mutations, can begin annual screening with MRI and mammography from age 30. However, there are no official guidelines for younger women, resulting in many high-risk patients missing timely diagnosis. This preventive “gap” calls for a reassessment of the age limits for beginning screening.

It is also noted that women under 50 make up about one-fifth of those undergoing annual screening but account for one-quarter of diagnoses each year. Experts emphasize that certain women, such as those with family history or known genetic mutations, face higher risk even at a young age. “This combination—stable incidence and disproportionately aggressive tumors—challenges the current age-based screening approach and supports the case for personalized risk assessments,” explained Dr. Destouni.

The consistency of these numbers for more than a decade also suggests that “this is not a short-term issue. It is a persistent public health problem that requires attention,” the researcher added.

Dr. Destouni advises younger women to remain vigilant, regularly examining their breasts for any changes and discussing risk factors with their doctors. “We can no longer assume that young age equals low risk. Timely assessment and personalized prevention save lives by enabling cancer detection at a more treatable stage,” she concluded.