Breast cancer remains the leading cause of cancer death among women aged 20 to 49 in the United States. According to doctors at NYU Langone’s Perlmutter Cancer Center, more young adults are being diagnosed with breast cancer, often at more advanced stages. This trend highlights the importance of increased screening, prevention, and education efforts.
Elizabeth Comen, MD, co-director of the Mignone Women’s Health Collaborative, and Mary L. Gemignani, MD, MPH, director of the Women’s Early Onset Cancer Program and chief of the Division of Breast Surgery at Perlmutter Cancer Center, addressed questions about this trend during Breast Cancer Awareness Month.
Dr. Gemignani noted that while most patients are diagnosed at age 62 or older, about 10 percent of current cases involve people aged 45 or younger. She said, “Over the last two decades, there’s been an increase in diagnoses in people age 20 to 29 and 30 to 39. We’re also seeing more aggressive molecular profiles among our younger patients, which poses a greater risk for prognosis and outcomes. Triple-negative breast cancer, a particularly aggressive subtype without many targeted treatment options, is also more common in younger women.” She added that “the American Cancer Society reported that women under 50 are nearly twice as likely to be diagnosed with cancer compared to men of the same ages. This is primarily attributed to increasing rates of breast cancer.”
Dr. Comen emphasized the need for education about risk factors and family history: “Education about risk assessment and family history is crucial in addressing the increasing number of breast cancer diagnoses among young people. Patients should openly discuss their family medical history with their primary care physicians and consider taking a breast cancer risk-assessment test.” She continued, “For women at average risk, beginning routine screening at age 40 is generally appropriate. However, those at higher risk may need to start screening earlier. Additionally, women with dense breasts may benefit from supplemental imaging—such as ultrasound or breast MRI—in addition to standard mammograms.”
She advocated for proactive communication: “We advocate for grassroots education: start the conversation with your primary care provider, learn your family history, and collaborate with your doctor to monitor and manage any symptoms. If something feels off, speak up. Trust your instincts.”
Dr. Gemignani highlighted challenges faced by younger patients navigating healthcare systems: “Health literacy and self-advocacy are also extremely important. Younger patients…are often navigating the healthcare system for the first time. A breast cancer diagnosis can be extremely overwhelming because there’s so much terminology and medical language that people may not understand.” She said building trust between care teams and patients helps empower individuals to make informed decisions.
Addressing support beyond medical treatment, Dr. Comen said: “At Perlmutter Cancer Center, we recognize that treating breast cancer goes beyond addressing the biology of the disease…Our approach is focused not only on treatment but also on preserving quality of life and helping patients maintain their roles and identities outside of their diagnosis.” She noted this includes supporting concerns related to fertility, parenting young children, career demands, nutrition, exercise, emotional wellbeing, sexual health, and overall daily functioning.
Dr. Gemignani described how lifestyle changes affect younger patients’ experiences: “When we established the Early Onset Cancer Program…In your 30s to 40s…your friends could be going on a night out, and you are buying a cold cap and getting ready for chemo.” She said survivorship has evolved into an individual experience honored by their program.
NYU Langone offers additional resources such as an Oncofertility Program that provides information about fertility options during cancer treatment: “One is the Oncofertility Program, which helps any cancer patient at NYU Langone understand and pursue their fertility options as part of their cancer treatment,” Dr. Comen said.
Dr. Gemignani noted other services launched include a Cardio-Oncology Program started in October 2024 that helps create personalized plans to protect heart health during or after treatment. The center also offers psychosocial support services such as rehabilitation programs and access to social workers.
She concluded by emphasizing commitment: “We are committed to providing younger cancer patients personalized care that meets their individual needs and gives them the best quality of life possible.”
