What to know
- Statistics Canada data shows breast cancer rates increased among women under 50 between 1984 and 2019, including those in their 20s, 30s and 40s.
- Dr. Toni Zhong, a plastic and reconstructive surgeon at UHN’s Princess Margaret Cancer Centre, says she has seen more younger women seeking breast cancer surgery and reconstruction in her practice.
- Potential risk factors include genetic mutations, hormonal exposure, alcohol consumption, smoking, excess weight and a sedentary lifestyle.
- Ontario women aged 40 to 74 can access a screening mammogram every two years through the Ontario Breast Screening Program without a doctor’s referral. Mammograms are covered by OHIP for eligible patients.
- Warning signs can include a lump in the breast or armpit, changes in breast size or shape, nipple changes and nipple discharge. Anyone who notices unusual changes should consult a health-care professional.
A Toronto expert is sharing tips on how women can prevent and detect breast cancer earlier, as data shows more young women are developing the disease.
According to Statistics Canada, breast cancer rates have been rising among younger women in the last decade, especially for those under 50 years old. Data shows the number of breast cancer cases among women between 40 and 49 years old has risen from 126.55 per 100,000 women to 140.76 between 1984 and 2019. Over the same period, the rate grew from 36.86 to 42.47 for those between 30 and 39 years old, and from 3.94 to 6.07 for those between 20 and 29.
Dr. Toni Zhong, a plastic and reconstructive surgeon at UHN’s Princess Margaret Cancer Centre, tells Now Toronto even though overall breast cancer rates have remained consistent over the last few years, she has observed a trend in her practice, with more women in their 20s and 30s seeking cancer surgery and reconstruction.
In addition to having become more common, Zhong said she has observed that cancer seems to also be manifesting more aggressively among younger women with the disease.
“I do think that diagnosis is definitely on the rise in younger patients. When I first started practice about 18 years ago, this was a disease that was associated with slightly older women, definitely 50-plus,” she explained.
“We no longer feel that way. I see women in their 40s a lot in my practice.”
Why are rates going up among younger women?
As explained by Zhong, there are many different explanations or theories for this trend, as a series of factors like genetics, biology, and environmental exposure have been linked to breast cancer risks. However, one of the main theories involves exposure to estrogen and progesterone levels.
According to the Canadian Cancer Society (CCS), women are naturally more exposed to these hormones as part of their reproductive health. Having an earlier first period or entering menopause later could increase risks associated with estrogen and progesterone exposure, as that could mean being exposed to these hormones for longer.
“The age at which girls are getting their periods is getting younger. Women reaching menopause are shifting to be earlier. So, that whole exposure of a woman’s lifetime to estrogen is shifted earlier. So it makes sense that breast cancer… has also shifted along with the whole life cycle,” Zhong said.
Certain genetic conditions like Li-Fraumeni syndrome, Ataxia-telangiectasia, or having CHEK2 or PALB2 gene mutations are also associated with higher breast cancer risks. Lifestyle habits like smoking, consuming alcohol, or being sedentary are also linked to the disease.
Regular screening recommendation
The Ontario Breast Screening Program (OBSP) recommends that women between 40 and 74 years old get a screening mammogram every two years.
Women in that age group do not need a referral from a doctor to get screened and can refer themselves to the procedure, which is covered by OHIP.
Although that is a good start, Zhong said she believes women in that age group should ideally get screened once a year, and assured that screenings don’t come with a higher risk of cancer due to radiation.
“There are people out there who say that mammograms cause a lot of radiation, and mammograms can cause breast cancer, so I do want to dispel that because that is so far from the truth,” she said.
“There is a low-level radiation involved with mammograms, but it is no different than air travel, and mammograms do not cause breast cancer. But what a mammogram can do is detect breast cancer that you may not be able to feel, and if it’s detected early, it’s very treatable.”
What signs women should watch out for
As explained by Zhong, early detection of breast cancer is crucial to effective treatment.
Detecting breast cancer in its earlier stages gives women a higher chance of survival and helps them avoid more harmful and invasive procedures like chemotherapy or radiation.
“Breast cancer progresses in a very predictable fashion. It first obviously involves the breast, and then it goes to the closest lymph node before it goes to your bloodstream. So if you catch it early, when it’s still isolated in your breast… that’s when it’s most treatable,” she explained.
Breast cancer can be detected in many ways, including through mammograms and the feeling of lumps in the breast tissue.
In fact, according to Zhong, feeling a lump in the breast is the most common sign of cancer, which can be helpful in identifying the disease early, especially among those under 40 who don’t receive regular screenings.
The expert recommends women self-examine their breasts once a month, ideally five days after getting their periods. This process involves visually inspecting the breasts to look for signs of lumps, as well as feeling both breasts with their fingers to detect lumps, including under their arms and under their collarbones. If they detect any uncommon signs or lumps, they should then look for a health practitioner.
“I think women in general should be doing their own self breast exams starting in their late 20s. And definitely in their 30s,” Zhong said.
“The more you get to know your breasts, the more you know your baseline, and the more you can detect a change. And I think that feeling a lump is probably still the most common change anyone will detect.”
Other changes to the breast might also be a sign of breast cancer, according to the CCS, including:
- A lump in the armpit
- Changes in shape or size
- Changes to the nipple
- Nipple discharge
How women can prevent breast cancer
Breast cancer comes with several risk factors and causes, which are different for each woman. However, certain habits and conditions can increase risks.
As pointed out by Zhong, excess weight and a sedentary lifestyle are both associated with a higher risk of cancer. Eating healthy, exercising constantly and avoiding spending extended periods of time sitting down can help reduce risks, according to the expert and the CCS.
Other habits, like smoking and consuming alcohol, are also associated with higher risks of the disease. Zhong recommends avoiding alcohol or at least consuming it more moderately to reduce risks.
October marks Breast Cancer Awareness Month. The disease affects thousands of women in Canada, with new diagnoses coming each year.
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According to the CCS, it is estimated that 32,400 women will be diagnosed with breast cancer in 2026, representing 26 per cent of all new cancer diagnoses in women. The disease also represents 13 per cent of all cancer deaths in 2026 among women, as the CCS estimates 5,400 will die from breast cancer by the end of the year.
