What to know about breast cancer

Breast cancer is the most common cancer in the United States, with The American Cancer Society estimating that 310,720 new cases of invasive breast cancer will be diagnosed in women in 2024.

But there’s something even more alarming: Breast cancer is becoming increasingly common in younger women. According to recent research, the incidence among women ages 20 to 49 was 64 cases per 100,000 people in the year 2000. In 2016, that number was 66—but by 2019, it had risen dramatically to 74. An increase from 66 to 74 (per 100,000) cases might not sound that large, but think about it this way:

Between 2000-2016, rates in women under 50 were increasing by 0.24% per year; from 2016-2019, the rate was suddenly rising by 3.76% annually. A jump from 0.24% to 3.76% is huge—and definitely something to pay extra attention to.

This guide covers what you need to know, including the basics of breast cancer and what could be behind this alarming trend in younger women.

The current state of breast cancer in the U.S.

While a breast cancer diagnosis is always disconcerting, there is some encouraging news: Death rates have been decreasing steadily since 1989, and this type of cancer is one of the more survivable—the five-year survival rates of breast cancer in the U.S. are:

• 91% for all types and stages
• 99% for localized (early-stage)

That impressive survival rate is due to several factors, including increased awareness, earlier detection through screening, and improved treatments.

While breast cancer is often talked about as a women’s health issue—and it is more prevalent in women by far—this cancer can also occur in men. There are approximately 2,650 men diagnosed with breast cancer each year in the U.S., making up about 1% of total breast cancer diagnoses.

Important facts about breast cancer

Before you can fully comprehend the trends in breast cancer diagnoses, it’s helpful to have a basic understanding of the disease. Here are a few must-know breast cancer facts to familiarize yourself with.

Types of breast cancer

There are many different types of breast cancers, but they’re generally split into two major categories:

• Invasive: The cancer has spread into the surrounding breast tissue (also called “infiltrating”)
• Non-invasive: The cancer has not spread beyond the breast tissue where it started (also called “precancer”)

There are several types and even subtypes in each of those categories, as that narrow classification helps doctors identify how the cancer develops and how to best treat it.

For example, invasive ductal carcinoma and invasive lobular carcinoma are two of the most common types of invasive breast cancer, with invasive ductal carcinoma alone making up 70 to 80% of all breast cancers.

Breast cancer risk factors

As The National Breast Cancer Foundation explains, researchers have found several factors that increase a person’s risk of getting breast cancer. Again, these are split into two distinct categories:

• Genetic risk factors: Factors that can’t be changed (e.g., biological sex, age, race, family history, personal health history, genome changes, and dense breast tissue)
• Lifestyle risk factors: Factors that can be avoided, managed, or changed (e.g., poor diet, sedentary lifestyle, excessive alcohol intake, or Combined Hormone Replacement Therapy)

Much like with any other type of disease, a healthy lifestyle can minimize a person’s risk of getting breast cancer—but there’s no way to eliminate the risk entirely.

Symptoms of breast cancer

When most people think of breast cancer symptoms, a lump in the breast or armpit is the first one to come to mind. However, different people can experience different symptoms. According to the CDC, in addition to a lump, there are several symptoms to watch for including:

• Thickening or swelling of part of the breast
• Irritation or dimpling of breast skin (uneven texture with small, pitted areas)
• Redness or flaky skin on the breast or nipple area
• Pulling in of the nipple or pain in the nipple area
• Nipple discharge including blood
• Changes in the size or shape of the breast
• Pain in any areas of the breast

Any one of these symptoms doesn’t necessarily indicate breast cancer. But when you notice one (or especially several) of the above signs, it’s best to contact a healthcare provider to discuss your concerns.

Breast cancer screening guidelines

When it comes to detecting breast cancer, mammograms (low-dose X-rays of the breasts) are the most common option. Typically, women don’t need to start annual mammograms until after the age of 40, at which point experts offer the following recommendations:

• Optional annual mammograms between 40 and 44
• Annual mammograms between 45 and 54
• Mammograms every other year over age 55

While those are the general guidelines, a woman’s risk level will dictate her suggested screening plan. Doctors can use something called the Breast Cancer Risk Assessment Tool (BCRAT) to estimate a woman’s risk of developing breast cancer.

Women who are determined to be at a higher risk start screening earlier (typically at age 30) and can also opt for an annual breast MRI in addition to a mammogram.

Some experts also encourage women to complete self-exams of their breasts at least once per month to check for changes or lumps. However, there’s surprisingly little evidence that these self-examples help with early detection of cancer. Even so, it doesn’t hurt for women to check and be aware.

Increase of breast cancer in younger women

The median age at the time of breast cancer diagnosis is 62. However, as discussed above, diagnoses in women under the age of 50 have been steadily increasing over the past five years.

Researchers have found that this increase among young women is almost entirely due to an increase in estrogen-receptor positive tumors, which means those breast cancer cells have high levels of estrogen that are helping them grow. There isn’t yet a clear answer as to why this type of cancer is rising dramatically among young women, but it’s an issue that researchers are actively exploring.

It’s a pressing concern for experts and healthcare professionals, as being diagnosed with cancer at a young age negatively impacts the prognosis.

Since most women don’t even begin cancer screening until after the age of 40, cancer cases in younger women are usually more advanced by the time they’re found and, as a result, are more difficult to treat. In fact, women under 40 are nearly 40% more likely to die from breast cancer than women over 40.

How Carrum Cancer Care can help

A cancer diagnosis is life-changing—but Carrum is here to help. We saw a huge need for helping employers connect their members to higher quality, affordable cancer care. That’s why we created our first-of-its-kind value-based cancer care program, which includes a cancer treatment program and a cancer advisory program.

For our cancer treatment program, we partner with some of the best cancer centers of excellence in the nation—Dana-Farber, Memorial Sloan Kettering, City of Hope, Florida Cancer Specialists, and more—to ensure members can receive high-quality treatment from providers who specialize in their particular cancer type. For our cancer advisory program, we partner with AccessHope, a subsidiary of City of Hope, to provide members with remote expertise from top cancer specialists.

Every member who comes to Carrum for cancer care, whether they join our treatment or advisory program, is connected with a cancer care navigator.  This team helps them understand their benefits and navigate the program and provides ongoing support throughout their journey.

From confirming a diagnosis and treatment plan to contracting with providers for a variety of cancer services (including surgery, chemotherapy, or radiation therapy and support services like nutrition, exercise, social work, and support groups), Carrum Health helps people access the high-quality care they need. Members receive this care for little to no cost, an incredibly important aspect of the program considering the financial toxicity that exists in cancer care. And, due to our pre-negotiated value-based contracts with our COEs, employers are able to save money on cancer care while still ensuring their members get the very best care.

Learn more about Carrum Cancer Care.

The information contained on this page is for informational purposes only. No material is intended to be a substitute for professional medical advice, diagnosis, or treatment.