Breast cancer rates rising among young women, Ottawa-based study finds

A new Ottawa-based study published in the Canadian Association of Radiologists Journal has found that rates of breast cancer in women as young as their 20s have been increasing. 

But the lead author, Dr. Jean Seely, says one big question remains unanswered following her team's work: why?

"What we're seeing is that women are getting breast cancer at this earlier age, at a higher, more alarming rate," said Seely, who is also the head of breast imaging at The Ottawa Hospital and a professor in the University of Ottawa's radiology department. 

"But what really surprised me was the extent of the increase."

The doctor told CBC Radio's All In A Day that for women in their 20s, the research team found a 45 per cent increase in cases over the past 35 years. 

For women in their 30s, it was a 15 per cent increase, with a nine per cent increase for women in their 40s.

"Possibly, this may be environmental. We think that there may be a change in lifestyle," Seely said.

"Women are actually getting their periods at an earlier age, and many women are delaying their childbearing into later [years]. And this may have some impact."

Alcohol usage is another possible factor, but Seely said many women have no identifiable risk factors prior to diagnosis.

"It points to [the fact that] there must be some other cause that we just aren't aware of," she said. 

Breast cancer survivor Chelsea Bland started a support group in Ottawa for other young women.

She was only 27 when she found a lump during a self-examination.

"I think a lot of us are motivated to understand why," Bland told All In A Day. "Is there anything that we can do to prevent it from recurring at this point? It's a hard thing to sit with when you don't understand why."

The explanation isn't simply that more cases are being detected through screening, said Seely, noting that women in their 20s and 30s aren't actively screened and that women in their 40s aren't being screened as much as they should be.

The Canadian Task Force on Preventive Health Care (CTFPHC) breast cancer screening guidelines are set to be updated next month. 

The current recommendations, last updated in 2018, recommend against broad screening of women in their 40s. But in light of her team's findings, Seely said the researchers are recommending just that.

Her team isn't recommending screening women younger than that, as they only make up about five percent of all breast cancer cases. 

Greater awareness needed

Seely said she believes the focus should really be on getting risk factors on younger women's radars through awareness campaigns.

"We should start to think about risk by age 30," Seely said. "That wouldn't have helped Chelsea, but the recommendations in the U.S. are to start [thinking about risks] between 25 and 30."

That means, for example, that if someone's mother was diagnosed with breast cancer at 45, screening should begin 10 years before that, Seely said.

Multiple risk factors could lower that bar further, she added.

Bland, who doesn't have a family history of breast cancer, said many people in her support group didn't know at what age they should have started screening.

"If we start to change the narrative that 'you're too young for breast cancer' to 'it can really happen at any age,' it might prompt younger folks to take the initiative," she said.