Rising Breast Cancer Cases in 20s: A Shift from the 50s and 60s

Breast cancer among young females, especially in India, has shown a steady rise over the years.

Currently, breast cancer in women under 40 constitutes nearly 10-12% of overall breast cancer cases, which is a significant increase compared to previous decades. Hence, we need to keep pace with these changing trends and revise our screening programs for early detection.

Today, treatment options are far more advanced than in earlier decades, with a focus on saving the breasts and improving prognosis. However, even to this day, the most important factor in determining prognosis is the stage at which the cancer is detected. Therefore, we must first accept the fact that our young girls in their 20s could also have cancer. Not all lumps in the 20s are fibroadenomas.

We have seen cases where young girls tell their mothers about lumps, but the mothers, out of ignorance or denial, dismiss the possibility of cancer. Later, these girls return with a worse prognosis. Dr. Namrata Singal Sawant, Director and Senior Breast & Women’s Imaging Consultant Radiologist at Vcare Imaging Diagnostic Center, Mumbai, shares all you need to know.

Another important point is the presence of the notorious cancer commonly found in young females, known as “Triple-negative breast cancer.” This cancer is difficult to differentiate from routine fibroadenomas or other tumors, like Phyllodes, even through imaging methods. Thus, unless these young girls are investigated with high suspicion by experts, there is a high risk of missing the diagnosis. The worst part is that this cancer grows extremely fast compared to other types, making early detection crucial.

The key factors contributing to this rising trend are:

Genetic factors: Mutations in the BRCA1 and BRCA2 genes play a major role in young breast cancer. Testing for these genes is important at a young age, especially if there is a family history of breast cancer.

Lifestyle changes: Sedentary lifestyles, obesity, smoking, alcohol consumption, and increased stress levels are also known to contribute to this trend.

Reproductive factors: Late pregnancies, reduced breastfeeding, and hormonal contraceptive use.
Screening Recommendations play a major role in early diagnosis and prognosis:

Regular monthly self-breast examinations.
Annual clinical breast examinations by clinicians starting at age 25.
Baseline mammogram or breast MRI for high-risk individuals, such as those with BRCA gene mutations or a positive family history. Screening for these individuals can begin a decade earlier than the age at which their family members were diagnosed.

Given these changing trends, we must take proactive steps to protect our young girls by updating our screening protocols and treatment options. The first step is to accept the rising incidence of breast cancer in young females.