Is Breast Cancer in Women Under 40 a Different Disease?
Given an otherwise similar cancer presentation, should women under 40 be treated differently from older women on the basis of age alone? The answer is not entirely clear. Even the age range that should be viewed as being at higher risk is somewhat controversial, with women under 35, 40, or 45 classified as “young” in different studies.[2-4] While breast cancer in women under 40 is rare, accounting for roughly 6.5% of all cases, it is more likely to be associated with high-risk features than the cancers seen in older women.[5] In addition, breast cancer in women under 40 may signal a BRCA mutation-and testing should be considered in all young patients- but for most young women a specific etiology is not identified. Breast cancers in young women are more likely to be estrogen receptor-negative and of higher grade.[6,7] Several studies suggest that HER2-positive disease is more common in younger women.[2,8] In addition, young African-American women are more likely to have triple-negative
