By Harshit
NEW YORK | December 2, 2025
A sweeping review of breast cancer cases across seven outpatient centers in Western New York has revealed a persistent and significant trend: one-quarter of all breast cancers diagnosed over an 11-year period occurred in women aged 18 to 49, including many under 40 — an age group with no standard screening guidelines.
The findings, presented at the annual meeting of the Radiological Society of North America (RSNA), raise urgent questions about whether current screening recommendations adequately protect younger, higher-risk women.
Study Reveals a Notable Gap in Screening Policies
“For women under 40, there are no formal screening guidelines,” said study author Dr. Stamatia Destounis, radiologist at Elizabeth Wende Breast Care (EWBC). “Yet this research shows that a substantial proportion of cancers occur in exactly that group.”
National data has hinted at rising breast cancer rates in younger women, but this multi-center review offers one of the most detailed regional analyses to date.
Currently:
- USPSTF recommends biennial mammograms starting at age 40
- American Cancer Society recommends annual screening starting at age 45
- High-risk women may begin MRI + mammogram around age 30
But no guidelines exist for women under 30, even when they have symptoms or substantial family history.
How the Study Was Conducted
Dr. Destounis and co-author Andrea Arieno, B.S., analyzed records from 2014–2024 across seven EWBC facilities covering a 200-mile region.
They focused on women aged 18 to 49, collecting detailed data including:
- How each cancer was detected
- Whether it was invasive or non-invasive
- Tumor biology and aggressiveness
- Screening vs. diagnostic discovery
Cases not representing primary breast cancer were excluded for accuracy.
Findings: Many Cases Were Aggressive and Invasive
The review identified:
- 1,799 breast cancers
- 1,290 women aged 18–49
- Average age at diagnosis: 42.6
- Youngest patient: 23
- 41% detected by screening
- 59% found during diagnostic evaluation
- 80.7% were invasive cancers
“Many of the invasive cancers were aggressive, especially in women under 40,” Destounis said. Some cases were triple-negative, a difficult-to-treat subtype lacking common hormone receptors.
Younger Women Consistently Represent 20–24% of All Diagnoses
Even though women under 50 accounted for only 21–25% of the screening population each year, they represented nearly one in four cancers diagnosed.
“This stable pattern tells us the issue isn’t temporary,” Destounis said. “It’s a long-term concern that demands attention.”
Even in years when fewer young women were screened overall, the absolute number of cancers remained unchanged — a sign that the need for earlier detection is not decreasing.
Why These Findings Matter
The data carries two central implications:
1. Younger women are not “low risk” by default
Tumors in young women tend to be:
- More biologically aggressive
- More likely to be invasive
- More likely to be detected only after symptoms appear
2. Screening guidelines may need to evolve
“We can’t rely on age alone,” Destounis said. “Risk-based assessment must begin earlier.”
Women with:
- A family history
- Known genetic mutations
- Dense breasts
- Personal risk factors
- Higher-risk minority backgrounds
…may benefit from earlier screening and tailored surveillance.
Rising Awareness for Younger Patients
Destounis emphasized that women under 40 should not dismiss symptoms:
- Palpable lumps
- Breast changes
- Pain or nipple discharge
- Family history of early breast cancer
Early clinical evaluation and risk assessment are essential.
“This data reinforces that young women absolutely can develop breast cancer — and often aggressive forms,” she said.
Conclusion
The findings present a compelling case for reevaluating age-based screening cutoffs. With younger women representing a stable and significant share of annual breast cancer diagnoses — many involving invasive or aggressive tumors — clinicians may need to adopt earlier, personalized risk assessment to improve outcomes.