Differences in breast cancer incidence among young women aged 20–49 years by stage and tumor characteristics, age, race, and ethnicity, 2004–2013
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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.
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.
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.
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.
KeywordsBreast cancer Young women Health disparities Tumor subtype Triple-negative breast cancer Cancer registries
American Indian or Alaska Native
Annual percent change
Asian or Pacific Islander
Human growth factor/neu receptor
International Classification of Diseases for Oncology third edition
National Program of Cancer Registries
Surveillance, epidemiology, and end results program
United States Cancer Statistics
This research was supported in part by an appointment (M.L. Shoemaker) to the Research Participation Program at the Centers for Disease Control and Prevention administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and CDC.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no conflict of interests.
- 4.Chollet-Hinton L, Anders CK, Tse C-K, Bell MB, Yang YC, Carey LA, Olshan AF, Troester MA (2016) Breast cancer biologic and etiologic heterogeneity by young age and menopausal status in the Carolina Breast Cancer Study: a case-control study. Breast Cancer Res 18(79):5Google Scholar
- 6.1999–2013 Incidence, WONDER Online Database (2016) US Department of Health and Human Services. United States Cancer Statistics. http://wonder.cdc.gov/cancer-v2013.html. Accessed 24 Dec 2016
- 19.Thornton ML (ed) (2014) Standards for cancer registries Volume II: data standards and data dictionary, record layout version 15, 19th ed., North American Association of Central Cancer Registries. Springfield, ILGoogle Scholar
- 20.National Program of Cancer Registries and Surveillance Epidemiology & End Results (2016) NPCR and SEER incidence—USCS 2001–2014 public use database data standards and data dictionary, vol. 2017Google Scholar
- 21.National Cancer Institute (2017) Surveillance Epidemiology and End Results (SEER) Program. Population estimates used in NCI’s SEER*Stat software. http://seer.cancer.gov/popdata/methods.html. Accessed 26 Oct 2017
- 22.Young JL Jr RS, Ries LAG, Fritz AG, Hurlbut AA (2001) SEER summary staging manual—2000: codes and coding instructions, National Cancer Institute. In: NIH Pub No 01-4969. Bethesda, MDGoogle Scholar
- 23.Surveillance Research Program National Cancer Institute: SEER*Stat software (seer.cancer.gov/seerstat) version 8.3.4Google Scholar
- 24.Gomez SL, Von Behren J, McKinley M, Clarke CA, Shariff-Marco S, Cheng I, Reynolds P, Glaser SL (2017) Breast cancer in Asian Americans in California, 1988–2013: increasing incidence trends and recent data on breast cancer subtypes. Breast Cancer Res Treat 164(1):139–147CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Kohler BA, Sherman RL, Howlader N, Jemal A, Ryerson AB, Henry KA, Boscoe FP, Cronin KA, Lake A, Noone A-M et al (2015) Annual Report to the Nation on the Status of Cancer, 1975–2011, featuring incidence of breast cancer subtypes by race/ethnicity, poverty, and state. J Natl Cancer Inst 107(6):djv048CrossRefPubMedPubMedCentralGoogle Scholar
- 28.Ambrosone CB, Zirpoli G, Ruszczyk M, Shankar J, Hong CC, McIlwain D, Roberts M, Yao S, McCann SE, Ciupak G et al (2014) Parity and breastfeeding among African-American women: differential effects on breast cancer risk by estrogen receptor status in the Women’s Circle of Health Study. Cancer Causes Control 25(2):259–265CrossRefPubMedGoogle Scholar
- 41.United States Preventive Services Task Force (2016) Final update summary: breast cancer: screening. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening1. Accessed 26 Oct 2017
- 42.American College of Obstetricians and Gynecologists (2011) Practice bulletin no. 122: breast cancer screening. Obstet Gynecol 118(2 Pt 1):372–382Google Scholar
- 44.International Agency for Research on Cancer (2015) IARC handbooks of cancer prevention, vol 15. Breast Cancer Screening, LyonGoogle Scholar
- 51.Interagency Breast Cancer and Environmental Research Coordinating Committee (2013) Breast cancer and the environment: prioritizing prevention. https://www.niehs.nih.gov/about/boards/ibcercc/index.cfm. Accessed 26 Oct 2017
- 52.Institute of Medicine (2012) Breast cancer and the environment: a life course approach. The National Academies Press, Washington, DCGoogle Scholar
- 53.Ekwueme DU, Allaire BT, Parish WJ, Thomas CC, Poehler D, Guy GP Jr, Aldridge AP, Lahoti SR, Fairley TL, Trogdon JG (2017) Estimation of breast cancer incident cases and medical care costs attributable to alcohol consumption among insured women aged < 45 years in the U.S. Am J Prev Med 53(3s1):S47–S54CrossRefPubMedPubMedCentralGoogle Scholar
- 56.Centers for Disease Control and Prevention (2017) Bring your brave compaign. https://www.cdc.gov/cancer/breast/young_women/bringyourbrave/. Accessed 26 Oct 2017
- 57.Centers for Disease Control and Prevention (2017) Interpreting Race and Ethnicity in Cancer Data. https://www.cdc.gov/cancer/npcr/uscs/technical_notes/interpreting/race.htm. Accessed 26 Oct 2017