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

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.

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Abbreviations

AIAN:

American Indian or Alaska Native

APC:

Annual percent change

API:

Asian or Pacific Islander

CI:

Confidence interval

ER:

Estrogen receptor

HER2:

Human growth factor/neu receptor

HR:

Hormone receptor

ICD-O-3:

International Classification of Diseases for Oncology third edition

NH:

Non-Hispanic

NPCR:

National Program of Cancer Registries

PR:

Progesterone receptor

SEER:

Surveillance, epidemiology, and end results program

TN:

Triple-negative

USCS:

United States Cancer Statistics

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Acknowledgements

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.

Disclaimer

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.

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Correspondence to Meredith L. Shoemaker.

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The authors declare that they have no conflict of interests.

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The dataset generated and analyzed during the current study is available in the U.S. Cancer Statistics repository, https://www.cdc.gov/cancer/npcr/public-use/index.htm.

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Shoemaker, M.L., White, M.C., Wu, M. et al. Differences in breast cancer incidence among young women aged 20–49 years by stage and tumor characteristics, age, race, and ethnicity, 2004–2013. Breast Cancer Res Treat 169, 595–606 (2018). https://doi.org/10.1007/s10549-018-4699-9

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Keywords

  • Breast cancer
  • Young women
  • Health disparities
  • Tumor subtype
  • Triple-negative breast cancer
  • Cancer registries