Evolution of Breast Cancer Incidence in Young Women in a French Registry From 1990 to 2018

Towards a Change in Screening Strategy?

Yanis Hassaine; Emmanuelle Jacquet; Arnaud Seigneurin; Patricia Delafosse

Breast Cancer Res. 2022;24(87)

Conclusion

Our results have shown an increase in the incidence of BC over the past thirty years, particularly affecting YW. It will be necessary to strengthen awareness campaigns on known modifiable risk factors and search for other potential risk factors such as environmental exposure. Progress is still needed in improving the identification of high-risk patients to increase the number of early diagnoses. Further research on the evaluation of personalized screening is required. In the meantime, the continuous improvement of survival thanks to new therapies brings important hope in the management of BC.

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Abbreviations
BC: Breast cancer; YW: Young women; BCYW : Breast cancer in young women; CI: Confidence interval; AAPC: Average annual percent change; ER: Estrogen receptor; PR: Progesterone receptor; HER2: Human epidermal growth factor receptor type 2.

Funding
None.

Availability of data and materials
Data supporting the findings of this study are available upon request from the corresponding author.

Declarations
Ethics approval and consent to participate
Our database is authorized by the National Commission for Information Technology and Freedom (CNIL), and there is a procedure for patient information.

Breast Cancer Res. 2022;24(87) © 2022 BioMed Central, Ltd.
Copyright to this article is held by the author(s), licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original citation.

Table 1. Standardized incidence rate per 100 000 women year of invasive breast cancer according to age from 1990 to 2018 (France, Isere Department)
	1990	1991	1992	1993	1994	1995	1996	1997	1998	1999	2000	2001	2002	2003	2004
< 40 years	8,9	9,2	11,8	14,5	14,5	12,2	13,2	12,8	16,4	10,8	17,7	10,8	12,0	11,0	15,2
40–49 years	156,3	178,8	181,0	151,5	193,9	173,8	185,2	152,9	182,2	173,1	178,7	176,5	199,1	208,6	192,6
50–74 years	267,6	275,9	279,5	273,4	260,8	268,2	284,4	325,8	287,9	272,5	318,7	346,2	356,6	360,9	356,9
≥ 75 years	250,8	270,4	249,3	272,6	320,8	256,4	300,2	288,9	316,6	284,1	279,4	293,9	247,5	307,9	347,2
All age	100,6	107,6	109,6	108,2	115,4	109,7	119,6	124,8	125,5	116,3	132,6	137,5	141,4	149,1	152,6
	2005	2006	2007	2008	2009	2010	2011	2012	2013		2014	2015	2016	2017	2018
< 40 years	13,6	16,5	16,8	22,6	18,0	15,2	19,1	14,9	19,1		17,4	14,5	19,4	16,2	22,4
40–49 years	207,3	198,2	193,6	206,7	211,0	168,8	213,2	184,9	188,8		184,6	200,1	204,7	186,2	229,2
50–74 years	324,8	328,4	320,3	345,2	319,1	307,8	323,1	328,6	322,1		320,6	320,5	341,4	323,5	329,9
≥ 75 years	342,5	271,7	288,9	310,0	348,9	337,0	361,3	325,3	306,8		340,3	345,0	354,4	346,7	376,5
All age	146,8	143,3	143,4	157,6	153,7	143,6	159,4	152,6	153,0		155,6	157,8	168,6	159,8	174,5

Table 2. Incidence rates by 5-year age group between 2011 and 2018
Age group	Number of case	Population	Incidence rate for 100,000 100 000
0–4	0	303,926	0,0
5–9	0	320,491	0,0
10–14	0	318,004	0,0
15–19	0	310,107	0,0
20–24	5	294,902	1,7
25–29	41	288,357	14,2
30–34	131	312,751	41,9
35–39	265	324,733	81,6
40–44	562	344,732	163,0
45–49	816	348,316	234,3
50–54	883	333,043	265,1
55–59	858	313,374	273,8
60–64	935	297,095	314,7
65–69	1052	263,594	399,1
70–74	864	200,111	431,8
75–79	576	170,320	338,2
80–84	537	150,328	357,2
85 +	598	175,446	340,8

Table 3. Average annual percentage of change by age from 2011 to 2018 (CI 95%)
Age group	Average annual percentage of change
< 40 years	+ 2,1% (–2,1%; + 6,2%)
40–49 years	+ 1,2% (–1,4%; + 3,2%)
50–74 years	+ 0,6% (–1,2%; + 1,3%)
≥ 75 years	+ 1,1% (–0,8%; + 3,4%)
All age group	+ 0,6% (–0,4%; + 1,6%)

Table 4. Average annual percentage of change according to age and tumor subtype from 2011 to 2018 (CI 95%)
	Triple negative	HER2 amplified	Luminal
< 40 years	+ 1,4% (–8,2; + 11,0)	+ 6,8% (–1,8; + 15,4)	–0,2% (–5,7; + 5,3)
40–49 years	–4,8% (–12,4; + 2,8)	+ 7,4% (+ 1,1; + 13,7)	–0,1% (–2,8; + 2,5)
50–70 years	–1,3% (–6,1; + 3,4)	+ 3,4% (–0,2; + 7,1)	–0,7% (–2,1; + 0,8)
≥ 75 years	+ 4,0% (–5,1; + 13,2)	+ 12,7% (+ 5,2; + 20,2)	+ 1,1% (–1,3; + 3,5)
All age	–0,8% (–4,2; + 2,6)	+ 6,0% (+ 3,2; + 8,7)	–0,1% (–1,2; + 1,0)

Table 5. 10-year relative survival of breast cancer by age from 1990 to 1999 and 2000 to 2008 (CI 95%)
	1990–1999	2000–2008
< 40 years	74,6% (69,6; 78,9)	78,3% (73,7; 82,1)
40–49 years	82,6% (80,3; 84,7)	87,3% (85,2; 89,0)
50–74 years	79,4% (77,7; 81,0)	88,3% (87,1; 89,4)
≥ 75 years	67,6% (62,2; 72,4)	71,5% (67,1; 75,4)

Table 6. 5-year relative survival of non-metastatic breast cancer by age according to tumor subtype from 2011 to 2013 (CI 95%)
	Triple negative	HER2 amplified	Luminal
< 40 years	86,9% (75,6; 93,1)	99,6% (94,7; 99,9)	97% (94,7; 98,3)
40–49 years	87,4% (79,7; 92,3)	99,9% (96,1; 99,9)	98,6% (97,5; 99,1)
50–74 years	88,7% (83,1; 92,5)	95,1% (90,6; 97,5)	98,4% (97,5; 98,9)
≥ 75 years	84,2% (72; 91,4)	90,7% (79,7; 95,9)	94,4% (91,3; 96,4)