Unique Issues for Women Under 40 with Breast Cancer
Read our blogs:
- I Was 30 When I Learned I had Breast Cancer
- Silvia’s Story: A Breast Cancer Diagnosis at 25
- An Opportunity to Live
About 4% of all breast cancers diagnosed in the U.S. occur in women under 40 [267].
A breast cancer diagnosis is shocking, especially for young women. At a time in life most often focused on family and career, issues of treatment, recovery and survivorship suddenly take top priority.
Survival
With treatment, the chances of survival for young women diagnosed with early breast cancer are good.
However, survival tends to be worse for women under 40 than for older women. This is because breast cancers in younger women can be more aggressive than breast cancers in older women [268].
Breast cancer in women under 40
Compared to breast cancers in older women, breast cancers in younger women are more likely to be [268]:
- Fast-growing
- Higher grade
- Hormone receptor-negative
Each of these factors makes breast cancer more aggressive and more likely to need chemotherapy [268].
Screening mammography isn’t recommended for women under 40 unless they have an increased risk of breast cancer. So, compared to breast cancers found in women 40 and older (who get regular mammograms), those found in younger women may be:
- More likely to be lymph node-positive
- Larger
However, tumor size isn’t as strongly related to breast cancer survival as other tumor factors. A large tumor may have better survival than a small tumor, based on tumor grade, hormone receptor status and HER2 status.
Genetic testing
If you’re diagnosed with breast cancer at age 40 or younger, you have an increased risk of having an inherited gene mutation related to breast cancer [9]. The National Comprehensive Cancer Network (NCCN) recommends you get genetic testing for BRCA1, BRCA2 and possibly other inherited gene mutations that increase breast cancer risk [9].
Learn more about genetic testing.
Treatment
Age
Age itself doesn’t greatly affect breast cancer treatment.
Treatment is based mainly on cancer stage and tumor characteristics, such as hormone receptor status and HER2 status.
However, age may play a role in the choice of certain treatment options. For example, younger women may be more likely than older women to get breast reconstruction after a mastectomy.
Learn more about factors that affect treatment options.
Menopausal status
Whether or not a woman has gone through menopause is important for some breast cancer treatments.
Hormone therapy drug options for women with hormone receptor-positive breast cancers depend on menopausal status. For example, premenopausal women may get ovarian suppression in addition to tamoxifen or an aromatase inhibitor.
Learn more about factors that affect treatment options.
Treatment options for ductal carcinoma in situ and invasive breast cancers
To learn more about treatment options, visit the pages below:
- Ductal carcinoma in situ (DCIS)
- Early and locally advanced breast cancer
- Inflammatory breast cancer
- Metastatic breast cancer
Breast cancer treatment and fertility
Young women with breast cancer may be concerned about loss of fertility (the ability to have a natural pregnancy).
Chemotherapy can damage the ovaries. Both chemotherapy and hormone therapy can impact fertility and shorten the window of time to have children.
Learn more about breast cancer treatment and fertility.
Preserving fertility
There are steps women can take to help preserve fertility.
If you wish to have a child after breast cancer treatment, talk with your health care provider (and if possible, a fertility specialist) about your options before making treatment decisions.
Meeting with a fertility specialist as early as possible (before surgery) offers the widest range of options.
The most common way to preserve fertility is to store eggs (fertilized or unfertilized) before chemotherapy begins.
Some women may use an ovarian suppression drug to help protect the ovaries from damage during chemotherapy.
Learn more about preserving fertility.
Learn about insurance coverage and financial assistance for fertility services.
Taking a break from hormone therapy to have a child
Women taking hormone therapy can talk with their oncologist about whether they can take a break to try to have a child and then return to hormone therapy to complete their full course of treatment [269].
A recent study looked at women ages 42 and younger who had stage I-III hormone receptor-positive breast cancer and wished to try and have a child [269]. The women in the study paused hormone therapy for up to 2 years to try to have a child [269].
After 3 years of follow-up, findings showed no evidence of an increased rate of breast cancer recurrence (breast cancer returning in the breast) or metastasis (breast cancer spreading to other parts of the body) in the women who paused hormone therapy [269-270].
Learn more about taking a breast from hormone therapy to try to have a child.
Other drug therapies and fertility
There are a number of new drug therapies for early breast cancer, including antibody-drug conjugate therapy, CDK4/6 inhibitor therapy, immunotherapy and PARP inhibitor therapy. We don’t yet understand the impact these new therapies might have on future fertility.
Talking with a fertility specialist
If you wish to have a child after breast cancer treatment, discuss your options with your health care provider (and if possible, a fertility specialist) before making treatment decisions.
Meeting with a fertility specialist as early as possible (before surgery) offers the widest range of options.
Birth control after a breast cancer diagnosis
Although chemotherapy and hormone therapy may temporarily stop periods, not all women will go into menopause. So, if you were premenopausal before breast cancer treatment, you may still become pregnant after treatment.
Current or recent use of birth control that contains hormones (such as birth control pills) is linked to a slight increase in the risk of breast cancer [361-362]. For women who’ve had breast cancer, there are concerns about using birth control that contains hormones and the risk of recurrence (a return of breast cancer) [363].
So, it’s important to talk with your provider before you begin using birth control containing hormones.
Learn more about birth control and breast cancer risk.
Methods of birth control that don’t contain hormones
Birth control options that don’t contain hormones include [363]:
- Copper IUDs (intrauterine devices that don’t contain hormones)
- Condoms or other barrier method
Talk with your health care provider about which type of birth control is best for you, including its benefits and risks.
Clinical trials for young women with breast cancer
Research is ongoing to improve all areas of treatment for breast cancer.
New therapies are being studied in clinical trials. The results of these studies will determine whether these therapies become part of the standard of care. Clinical trials can also study other parts of care, such as ways to manage side effects.
After discussing the benefits and risks with your oncologist, we encourage you to consider joining a clinical trial if there’s one right for you.
Read our blog, Four Things to Know About Clinical Trials When You’re Diagnosed with Breast Cancer.
Susan G. Komen® Patient Care Center |
If you or a loved one needs information or resources about clinical trials, the Patient Care Center can help. Contact the Komen Breast Care Helpline at 1-877-465-6636 or email clinicaltrialinfo@komen.org. Se habla español. |
BreastCancerTrials.org in collaboration with Komen offers a custom matching service. This matching service can help find clinical trials for fertility preservation.
Learn what else Komen is doing to help people find and participate in breast cancer clinical trials, including trials supported by Komen.
You can also visit the National Institutes of Health’s website to find a clinical trial.
Learn how Komen-funded research is improving treatment for breast cancer.
Learn more about clinical trials.
Insurance and financial assistance
Many hospitals have financial counselors who can discuss insurance and cost coverage with you.
A financial counselor can also help you navigate any insurance issues. They may be able to arrange a payment plan for hospital-related costs.
Fertility services
Insurance coverage for fertility services varies widely. Check with your insurance company to find out which procedures are covered in your policy.
Organizations such LIVESTRONG Fertility offer financial help if your insurance company doesn’t cover these services.
LIVESTRONG Fertility also offers information on fertility options.
Learn more about other financial assistance programs.
Prescription drug assistance
Drug costs can quickly become a financial burden for you and your family.
Medicare and many insurance companies offer prescription drug plans. One may already be included in your policy, or you may be able to buy an extra plan for prescriptions.
Some drugs are off-patent and may have a generic form. Generic drugs cost less than the name brands but are just as effective.
Many hospitals have financial counselors who can discuss insurance and cost coverage with you.
You may qualify for programs that help with drug costs or offer low-cost or free prescriptions. A financial counselor or social worker at your hospital can help you learn about these programs.
Learn more about insurance plans and prescription drug assistance programs.
Learn more about other financial assistance programs.
Other medical and personal expenses
Insurance issues (for example, a claim is denied) can be a major concern while you’re being treated for breast cancer.
Paying out-of-pocket expenses related to your treatment can also be a burden. This can lead to struggles paying other expenses such as rent, groceries and car payments. There are financial assistance programs that may help. A financial counselor or social worker at your hospital can help you learn about these programs.
Learn about insurance and financial assistance programs.
Learn about maintaining health insurance if you lose your job, change jobs, or need to take time off during your breast cancer treatment.
Travel, lodging, childcare and eldercare
Getting to your breast cancer treatments can be hard, especially if you don’t live near the hospital or medical center.
There may be resources available if you need a ride to and from treatment or help with childcare or eldercare. Family and friends often want to help but don’t know how. These are great ways for them to get involved. It’s OK to ask for help.
There may be some programs that help with local or long-distance transportation and lodging (if you need a place to stay overnight during treatment).
There may also be programs to help you with childcare or eldercare costs.
A social worker, patient navigator or financial counselor at your hospital can help connect you with these resources. You can also contact Komen’s Patient Care Center at 1-877 GO KOMEN (1-877-465-6636) or email helpline@komen.org.
Learn more about transportation, lodging, childcare and eldercare assistance programs.
Learn about resources that offer social support and practical support.
Komen Financial Assistance Program |
Susan G. Komen® created the Komen Financial Assistance Program to help those struggling with the costs of breast cancer treatment by providing financial assistance to eligible individuals. To learn more about this program and other helpful resources, call the Komen Patient Care Center at 1-877 GO KOMEN (1-877-465-6636) or email helpline@komen.org. Se habla español. Learn about other financial assistance programs. |
Support
Social support is important for young women diagnosed with breast cancer. It’s also important for loved ones, especially spouses, partners and children.
Learn more about social support for young women diagnosed with breast cancer.
Learn more about social support for spouses, partners and other family members.
Find our resource for talking with your spouse or partner about your breast cancer diagnosis.
Learn more about social support for children.
Find our resource for talking with children about your breast cancer diagnosis.
Susan G. Komen® Support Resources |
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*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date.
Updated 03/27/26
This content is regularly reviewed by an expert panel including researchers, practicing clinicians and patient advocates.