Expect Questions from Younger Women about Breast Cancer  

Get Permission

Young women need to know what is normal for them and understand that they need to go to the doctor if a change in their breasts occurs.

—Rebecca H. Johnson, MD

“SEER data showed a small but statistically significant increase in the incidence of breast cancer with distant involvement for women aged 25 to 39 years,” concluded a study published in the Journal of the American Medical Association.1 “The trajectory of the incidence trend predicts that an increasing number of young women in the United States will present with metastatic breast cancer in an age group that already has the worst prognosis, no recommended routine screening practice, the least health insurance, and the most potential years of life.”

Breast Awareness for Young Women

So what can these young women do to protect themselves against advanced breast cancer with distant metastases and poor prognosis? The study’s lead author, Rebecca H.
Johnson, MD
, supports efforts to teach adolescent girls and young women to be aware of their bodies, including their breasts, because previous research has shown that breast cancer is the most common malignant tumor in women between the ages of 15 and 39.

“Young women need to know what is normal for them and understand that they need to go to the doctor if a change in their breasts occurs,” Dr. Johnson told The ASCO Post. “In women under 40, who are obviously not a screened population,” she noted, “at least half of the breast cancers are detected by patients themselves.” Dr. Johnson is Medical Director of the Adolescent and Young Adult Oncology Program at Seattle Children’s Hospital and Assistant Professor at the University of Washington in Seattle.

It is also important that physicians who care for these young patients realize that “breast cancer can and does occur,” and they should not be dismissive of breast changes noticed by patients or “blow off new symptoms,” Dr. Johnson added. If changes are noted, physicians “should not watch and wait for a prolonged period of time.”

Not Advocating Screening Mammography

“We’re certainly not advocating that young women get mammography at an earlier age than is generally specified,” Dr. Johnson said in an interview with The New York Times,2 one of several national media outlets reporting on the breast cancer study. She explained that there is no evidence that screening mammography helps younger women who are at average risk of breast cancer.

“Women who have a known breast cancer predisposition syndrome—BRCA1 or BRCA2 mutations—would be an exception to the rule of not being screened, as would women who received chest radiation as young adults or teenagers for lymphomas or for any other reason,” Dr. Johnson stated. “They should be screened because they are a very high-risk population, but that’s obviously a small minority of all women under 40.” ■

Disclosure: Dr. Johnson reported no potential conflicts of interest.


1. Johnson RH, Chien FL, Bleyer A: Incidence of breast cancer with distant involvement among women in the United States, 1976 to 2009. JAMA 309:800-805, 2013.

2. Grady D: Advanced breast cancer may be rising among women, study finds. New York Times. February 26, 2013.

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