​​​​​​​​​​​​​More women under age 50–especially Black women–are being diagnosed with breast cancer.

While doctors and scientists don't yet know what's driving this trend, Julie Specht, MD, medical oncologist at The Christ Hospital Physicians, says a recent study provides opportunities to analyze information about age, race and tumor characteristics to develop new prevention strategies.

“Follow-up studies are coming," Dr. Specht recently told Local 12 Health Reporter Liz Bonis. “These may help us look at who we should be screening earlier."

A dramatic increase in breast cancer diagnoses

Research from the Washington University School of Medicine in St. Louis shows diagnoses of breast cancer in women ages 20 to 49 increased substantially between 2000 and 2019.

• From 2000 to 2016, the diagnosis rate grew about 0.24% a year
  
• After 2016, the rate increased dramatically to 3.76% a year

Looked at another way:

• In 2000, 64 women out of 100,000 were diagnosed with breast cancer
  
• In 2016, 66 women out of 100,000 were diagnosed
• By 2019, 74 women out of 100,000 were diagnosed

“This is especially concerning because women won't often get mammograms until they are 40 or 45," Dr. Specht said. “These women are not screened and could be at risk."

The impact of race on breast cancer rates

Women of different racial backgrounds are diagnosed with breast cancer at different rates. The Washington University study found Black women are:

• 53% more likely to be diagnosed with breast cancer between ages 20 to 29 than white women of the same age.
  
• 15% more likely to be diagnosed with breast cancer between ages 30 to 39 than white women.

After age 40, the incidence of breast cancer in Black women drops below that of white women. Hispanic women had the lowest rate of breast cancer at any age.

Early-stage and late-stage cases are more common

Most of the growing number of breast cancer cases being found in young women are stage 1 or stage 4 tumors, according to the study.

Young black women are being diagnosed with more aggressive or later-stage cancers, said Dr. Specht. Researchers hope future studies reveal what's driving these trends.

“Are women paying more attention and doing breast self-exams? Are young women finding tumors earlier?" Dr. Specht says. “We don't know."

Hormone drivers

Most of the new breast cancer cases are tied to tumors that are estrogen-receptor positive. These tumors feed off estrogen, according to Dr. Specht.

Future studies will try to determine how and why estrogen is a breast cancer driver. What is known is that estrogen-receptor positive breast cancer is more likely in women who:

• Are obese
  
• Have children at a later age
• Have fewer pregnancies.

Know your risks

This recent study backs up other findings that show there is a vulnerable group of women who need more prevention efforts, Dr. Specht said.

Future studies will work to identify the cause of the increased breast cancer rates. The goal is to find ways to reduce the risk of breast cancer for young women and develop new prevention and screening tools.

Dr. Specht said efforts could include using artificial intelligence, public outreach and other new ways to get information to at-risk young women.

Until then, Dr. Specht encourages all women of any age to discuss their family medical history with their doctors.

“Know your risk and learn to advocate for yourself," said Dr. Specht.

Complete a monthly breast self-exam

A great way to spot changes in breast tissue early is to complete a monthly breast self-exam.

The best time to do an exam is about a week after your period ends. Your breasts are less likely to be swollen. If you do not have regular periods, complete the exam on the same day every month.

• Lying down. Lie down with a pillow under one shoulder. Place the arm of that shoulder above your head. With the three middle fingers of the opposite hand, feel for lumps in the breast tissue. Press firmly. Move around the breast in a circular up-and-down line. Repeat on the opposite breast.

• While standing. Repeat the exam while standing with one arm behind your head. Performing the standing exam in the shower may make it easier to feel some breast changes.

• Before a mirror. Stand naked before a mirror with your hands at your sides. Look for dimpling or lumps. Lift both arms above your head and look for changes in the shape or size of your breasts or the texture of your skin. Note any nipple discharge other than milk.

Warning signs: If you notice any of the changes listed below, contact your doctor right away.

• ​A lump in the breast:
  
• Type: firm, soft, moveable or stationary
• Size: dime, nickel, quarter, half dollar
• Edges: smooth or rough
• Abnormal nipple deviation from the center
• A change in the skin of the nipple
• New dimpling of the nipple
• Discharge or bleeding from the nipple
• An unusual increase in the size of one breast
• One breast is unusually lower than the other
• Puckering of the skin of the breast
• Enlargement of the lymph nodes
• Localized pain
• Unusual swelling of the upper arm