An American woman in her 30s has a one in 232 chance of getting the disease, and a woman 20 years her senior has a 1 in 42 probability.
“Although we aren’t certain, breast cancer in younger women is likely caused by a genetic predisposition,” says Ann H. Partridge, M.D., M.P.H., the medical oncologist director of the Adult Survivorship Program at Dana-Farber Cancer Institute and Brigham and Women’s Hospital.
While breast cancer treatment in young women is often effective, the chance of recovery tends to be worse in women under 40. Breast tissue is often denser in younger women, making cancer harder to detect initially.
This is why many younger women are diagnosed at later stages with more aggressive tumors. These factors all contribute to an increased need for stronger treatments, says Partridge.
Unfortunately, some of these therapies have side effects that hit younger women in different and sometimes more difficult ways than their older counterparts.
At the time of diagnosis, many young women are in the midst of building careers, getting married and starting families. A major concern for young women with breast cancer is loss of fertility. Both chemo and hormone therapies can damage the ovaries, causing irregular periods or a menopausal transition.
For women in their 20s and 30s who continue to have their periods after chemotherapy, the ability to have children is still possible. Women who may want to become a parent after breast cancer should speak with their doctor about their options before choosing a treatment.
Those who are diagnosed after starting families also face unique challenges.
“It was difficult being 25 years old and finding out I had breast cancer, but it was even harder to figure out how to explain what was going on to my 4-year-old son,” says Crystal King, an eight-year survivor and the manager of multicultural marketing for Susan G. Komen for the Cure Circle of Promise.
Another source of distress among young women with breast cancer is the way their appearance will be affected by treatments. Healthy or not, a woman's happiness with her breast size and shape can have an impact on her overall body image.
More than 307,000 breast implant augmentation surgeries were performed in 2011. This is just an example of women looking to their breasts for a confidence boost—and young women facing breast cancer are no exception.
The under-40 demographic tends to have greater emotional distress over how cancer treatments will affect their appearance than their older counterparts.
King had just gotten engaged a few months prior to her diagnosis, and was “a bit upset by the thought of a mastectomy.”
“My mother was not at all concerned with how it would impact her life, nor was she in a rush to have reconstruction surgery," says King, whose mother was diagnosed with breast cancer at the age of 50. “But, as I always tell other women, nothing is ever as important as your health. You can walk around happily with your implants or you can lay in your grave with your 'real' ones. The choice is yours.”