Breast cancer deaths shift toward younger women as older patients see better survival

A national study analyzing U.S. breast cancer data spanning nearly 50 years has uncovered a major shift in outcomes and risk of developing the disease, highlighting urgent gaps in prevention and treatment for specific groups of women. Analyzing Surveillance, Epidemiology and End Results (SEER) data from 1975—2022, researchers from Houston Methodist found that breast cancer deaths, once concentrated mostly among older women, are increasingly affecting younger women, signaling a major change in the nation’s breast cancer risk landscape. While the data showed that survival improved substantially among older women over time, younger women did not experience the same improvement.

The research was led by Stephen Wong, Ph.D., the John S. Dunn Presidential Distinguished Chair in Biomedical Engineering at Houston Methodist and director of T. T. & W. F. Chao Center for BRAIN. The study appears in npj Breast Cancer.

“Rising mortality among younger women alongside improved survival in older women shows how breast cancer risk is shifting,” Wong said. “Importantly, we found that Asian women under 50 experience poorer outcomes and face elevated risk of mortality than previously recorded.”

Young Black women with triple‑negative breast cancer remained the highest‑risk group. However, the study also found elevated mortality risks among Hispanic and Asian women under 50 in specific molecular subtypes, particularly those with triple‑negative breast cancer, a more aggressive type of the disease.

According to the American Cancer Society, aside from skin cancers, breast cancer is the most common cancer in women in the United States, accounting for about 1 in 3 of all new female cancers each year. Breast cancer is also the second leading cause of cancer death in women, after lung cancer.

“Age, race and tumor type should not be treated as separate issues as they interact to drive these disparities,” said first author Lin Wang, research fellow in the Wong Laboratory at Houston Methodist. “When we look at them together, we uncover risks that would otherwise remain hidden.”

Wang said the findings support more age-aware, subtype-specific and population-aware approaches to breast cancer research, screening and care.

Other collaborators on the study include Houston Methodist’s Zhihao Wan, Vikramjit Dhillon, Xin Wang, Yin Zheng, Chika Ezeana, Polly Niravath, Akshjot Puri, Kai Sun and Jenny Chang.

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