Rise in breast cancer among South African women under 40 concern

Breast cancer, the most prevalent cancer among South African women, is increasingly detected in women under 40.

This trend mirrors global patterns, where younger women are being diagnosed with more aggressive forms of the disease, underscoring the need for early detection and awareness.

A recent study in the US found that breast cancer is the leading cause of cancer death among women aged 20 to 49 years in the US. Similarly, a South African study reported that the average age of breast cancer diagnosis for women under 40 was 34 years. Across all ages, breast cancer affects 1 in 27 women in South Africa, accounting for 23% of all cancers diagnosed.

As October marks Breast Cancer Awareness Month, the Breast Imaging Society of South Africa (Bissa), a sub-specialty group of the Radiological Society of South Africa, has warned that young women are more likely to develop breast cancers with aggressive biological characteristics. These cancers often present with larger tumours and more advanced stages of the disease at diagnosis, making early detection vital for improving outcomes.

Bissa chair Dr Peter Schoub emphasised the importance of early detection through regular self-examinations starting in a woman’s 20s, and annual mammograms from age 40.

Schoub said awareness and education can lead to early diagnoses and less invasive treatment.

“The growing number of younger women being diagnosed with breast cancer highlights the need to expand awareness campaigns and improve screening programmes, especially for those at higher risk.”

One of the biggest hurdles in South Africa remains the late-stage diagnosis of breast cancer, which severely limits treatment options and reduces survival rates. Late diagnosis is often attributed to factors, including a lack of awareness, socio-economic disparities, and limited access to health-care facilities.

“Although most major medical schemes offer complimentary mammogram screenings for women over 40, only about 20% of women take advantage of this service,” said Schoub.

“We must also be mindful that breast cancer is increasingly being detected in women in their 30s, who experience more aggressive forms of the disease that can spread rapidly if not detected early.” Schoub said women of all ages, races, and socio-economic backgrounds can be affected.

“This is why routine self-examinations and clinical breast checks by a health-care professional at least once a year are essential. Any abnormality, regardless of age or family history, should be evaluated by a medical professional immediately.”

He said the goal of breast cancer screening is to detect the disease before symptoms emerge.

“Cancers found through routine screening are often smaller and localised, increasing the chances of successful treatment and survival. The size of the tumour and whether the cancer has spread are key factors in determining the prognosis.”

Although every woman is at risk for breast cancer, certain factors increase the likelihood:

• Age: The risk of developing breast cancer increases as one gets older, however 1 out of 8 invasive breast cancers are found in women younger than 45.

• Family history: Women with close blood relatives who’ve had breast cancer are at higher risk.

• Personal history: A woman with cancer in one breast has a 3-4 times increased risk of developing a new cancer in the other breast or in another part of the same breast.

• Dense breast tissue: Women with dense breast tissue (as identified on a mammogram) have more glandular tissue and less fatty tissue and thus a higher risk of breast cancer.

• Overweight or obese women: Research in the past has shown that being overweight or obese increases the risk of breast and other cancers.

• Lifestyle: Excessive alcohol consumption, lack of physical activity, smoking, and diets high in saturated fats contribute to risk.

• Hormonal factors: Women who have not had a full-term pregnancy or have their first child after age 30 have a higher risk of breast cancer compared to women who gave birth before age 30. Breastfeeding can lower breast cancer risk, especially if a woman breastfeeds for longer than one year.

Women who started menstruating younger than age 12 have a higher risk of breast cancer later in life. The same is true for women who go through menopause when they are older than 55. Current or recent past users of hormone replacement therapy (HRT) have a higher risk of being diagnosed with breast cancer.

Cape Times