Breast cancer before 40: Younger patients face higher odds of delayed diagnosis

by Wiley

edited by Sadie Harley, reviewed by Robert Egan

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In an analysis of data on adolescents and young adults with breast cancer, lower income and younger age were linked with delays in care. The analysis, published online in Cancer, also found that women who experienced delays in cancer diagnoses tended to have later-stage disease.

Breast cancer diagnosed before age 40—which is before the recommended screening age—often carries a poor prognosis, along with unique treatment and psychosocial challenges. Because younger women tend not to undergo screening and may face delays in responding to breast cancer–related symptoms due to potential biases that they are not old enough to have cancer, investigators conducted a study to understand the impact of patient and tumor characteristics on delays in care and the impact of delays on cancer outcomes.

Tracking delays from symptoms to treatment

In the analysis of data on 1,071 individuals enrolled in the Young Women's Breast Cancer Study, a multisite prospective cohort of young women diagnosed with breast cancer by age 40, the team identified 153 presentation delays, 120 diagnostic delays and 228 treatment delays.

Presentation delays were defined as ≥90 days from the time of the first patient-reported symptom(s) to presentation to a clinician. Diagnostic delays were ≥90 days from the first health care visit for symptom(s) to the date of a biopsy resulting in a breast cancer diagnosis, and treatment delays were defined as ≥60 days between diagnosis and first treatment.

Income and age linked to delays

After adjusting for influencing factors, lower annual income was associated with higher odds of presentation delay, while pregnancy at diagnosis, family history of breast cancer and triple-negative breast cancer were associated with lower odds of presentation delay. Presentation delays were also associated with later-stage disease in women with certain HER2-positive tumors.

Odds of diagnostic delay were higher for younger patients and lower for those with triple-negative tumors. Those who experienced a delay in breast cancer diagnosis were more likely to have late-stage disease. Patients with more aggressive tumor types were less likely to have treatment delays.

Later-stage disease may increase treatment burden

Delays were not associated with cancer-free or overall survival, but the authors noted that a later stage at diagnosis may require more extensive surgery, radiation or systemic therapy that can affect quality of life and other outcomes.

"Our study reveals continued issues in care delay among patients with young-onset breast cancer and emphasizes a need to improve both patient and provider understanding of young-onset breast cancer risk factors and symptoms to decrease disease burden among these patients," said senior author Kristen D. Brantley, Ph.D., MPH, of the Dana-Farber Cancer Institute.

Publication details

Delays in breast cancer presentation, diagnosis and treatment in young women, Cancer (2026). DOI: 10.1002/cncr.70594

Journal information: Cancer

Clinical categories

OncologyWomen's healthCommon illnesses & Prevention Provided by Wiley Who's behind this story?

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →

Robert Egan

Bachelor's in mathematical biology, Master's in creative writing. Well-traveled with unique perspectives on science and language. Full profile →

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