Young Women's Breast Cancer Deaths Plummet Over Decade
New research highlights a substantial improvement in survival outcomes across all molecular subtypes and racial groups, suggesting that precision medicine approaches are having meaningful impacts, even as the disease becomes more common in women younger than 50 years. The results of a study presented at the American Association for Cancer Research (AACR) Annual Meeting 2025, which analyzed trends across molecular subtypes and racial groups, adds granularity to the recent Annual Report to the Nation on the Status of Cancer and the Breast Cancer Statistics 2024 report.
The research presented at the meeting focuses specifically on younger women aged 20-49 years, a group often underrepresented in cancer mortality analyses. Its findings, which are currently under peer review for publication, suggest that advances in breast cancer management are making significant impacts on survival outcomes for younger women, according to Adetunji Toriola, MD, PhD, MPH, who presented the findings at a press conference, at AACR.
Study Rationale and Methodology
The research was motivated by the team's earlier findings showing increases in breast cancer incidence among younger women in the United States; increases in breast cancer incidence were observed across all ethnic and racial groups.
'One of the most fascinating findings in this study was that the incidence of breast cancer among women of the more recent birth cohort, particularly in the 1980 birth cohort, was 25% higher than women of previous birth cohorts,' said Toriola, professor of surgery and co-lead of the Cancer Prevention Program at Siteman Cancer Center, Washington University School of Medicine, St. Louis, during the press conference.
This rising incidence prompted the researchers to investigate whether mortality patterns followed similar trends. Using SEER-17 registry data, they analyzed 112,826 breast cancer cases and 11,661 breast cancer–specific deaths among women aged 20-49 years diagnosed with primary invasive breast cancer between 2010 and 2020.
The team used incidence-based mortality methodology, which 'allows for more precise attribution of deaths to the specific cancer diagnosis compared to mortality estimates from death certificates,' Toriola said. Joinpoint regression models were used to identify significant changes in mortality trends over time.
Marked Declines Across Subtypes and Racial Groups
The analysis revealed substantial drops in mortality across all molecular subtypes, with particularly sharp declines beginning around 2016. Overall, incidence-based mortality declined from 9.70 per 100,000 in 2010 to 1.47 per 100,000 in 2020. This decline was consistent across molecular subtypes, including luminal A, luminal B, human epidermal growth factor receptor 2 (HER2)–enriched, and triple-negative breast cancer (TNBC).
For luminal A breast cancer, mortality decreased consistently from 2010, with a more pronounced decline after 2017 (annual percent change [APC], −32.88; 95% CI, −55.17 to −21.30). TNBC showed a similar pattern, with a marked decline beginning in 2018 (APC, −32.82; 95% CI, −41.47 to −17.79).
When examined by race and ethnicity, the data showed substantial improvements across all groups, though racial disparities persist. Non–Hispanic Black women had higher incidence-based mortality in both 2010 (16.56 per 100,000) and 2020 (3.41 per 100,000) than non–Hispanic White women (9.18 per 100,000 in 2010 and 1.16 per 100,000 in 2020).
'In other races, we had a cluster of about between 7 and 10 per 100,000 women for incident-based mortality in 2010, which reduced to between 1 and 2 per 100,000 in 2020,' Toriola noted during the press conference.
Importantly, the data indicated more pronounced mortality reductions beginning around 2016-2017 in many subgroups. For non-Hispanic American Indian and Alaska Native women, there was an almost 50% reduction in incidence-based mortality from 2018 onward. Toriola attributed these accelerated improvements to the introduction of novel targeted therapies during this period.
Age- and Subtype-related Survival Differences
The study highlighted marked long-term survival differences between age subgroups. Women aged 20-39 years had an 86.6% 5-year relative survival compared with 92% for women aged 40-49 years, while 10-year survival rates were 78.5% and 87.6%, respectively. According to Toriola, this finding highlights the need for targeted screening in high-risk populations younger than 40 years.
Younger women 20-39 years old with luminal A breast cancer showed worse survival outcomes than those with luminal B cancer after the 5-year mark. Toriola described this finding as unexpected, as luminal A breast cancer is typically considered to have the most favorable prognosis.
'We noticed that at the start of follow-up, the survival rates for women with luminal A and luminal B were identical, but this graph started separating as early as year 1,' explained Toriola. 'By year 5, the 5-year relative survival for women with luminal B was better than for women with luminal A, which is not what we would expect.'
When asked about this finding, Ann Partridge, MD, MPH, of Dana-Farber Cancer Institute, Boston, who was not involved in the study, said that, although unexpected, this phenomenon has been observed previously.
'This is consistent with what we see clinically and have seen in prior studies,' Partridge stated in an interview. She referenced previous research documenting this pattern in younger women with breast cancer.
Persistent Racial Disparities in Survival
Although overall mortality decreased, survival analyses revealed that non–Hispanic Black women continue to have the worst survival outcomes. At the 10-year follow-up, all racial groups except non–Hispanic Black women had relative survival rates above 80%. For non–Hispanic Black women, the 10-year relative survival rate was 75.5%.
When asked about factors contributing to persistent racial disparities, Partridge emphasized: 'I think much of the story here is access to care and treatment, and adherence to therapy. I am not sure of any clear biological or treatment response issues that have been validated definitively in this setting.'
Although the higher overall mortality among Black women with breast cancer aligns with the Annual Report to the Nation on the Status of Cancer and the Breast Cancer Statistics 2024 report, the research presented at the AACR went one step further to analyze racial disparities in long-term survival by tumor subtype specifically in younger women. The lowest long-term mortality across subtypes and races was observed for non–Hispanic Black women with TNBC (10-year survival: 67.1%), followed by Hispanic women with TNBC (10-year survival: 70.8%) and non–Hispanic Black women with ERBB2-enriched breast cancer (10-year survival: 74.1%).
Therapeutic Advances Driving Improved Outcomes
Toriola suggested that the dramatic mortality reductions, particularly after 2016, likely reflect significant advances in breast cancer management, particularly novel targeted therapies.
When asked about therapeutic advances that have likely contributed to improved outcomes in younger patients with breast cancer, Partridge said: 'For young-onset patients, the majority of whom have ER+ disease, the increasing role of ovarian function suppression and addition of aromatase inhibitors and associated risk reduction in early stage disease likely is having a big effect.'
Partridge added that young women are also more likely to have TNBC or HER2+ disease, two of the more aggressive subtypes that now have new therapies, including immunotherapy and anti-HER2 therapy, respectively. 'Their increasing use and associated survival advantages are also improving young-onset disease outcomes,' she said.
When questioned about the relative contribution of screening vs treatment advances, Toriola noted, 'Both have contributed significantly to reductions in mortality.' Indeed, a 2024 study estimating the number of breast cancer deaths averted from prevention, screening, and treatment efforts between 1975-2020 showed that treatment advances contributed to about 75% of the deaths averted, and mammography screening contributed to the remaining 25% of the deaths averted.
Clinical Implications
Considering the lower 10-year survival among women aged 20-39 years than women aged 40-49 years, Toriola suggested that targeted screening in high-risk populations aged 40 years or younger may be needed.
Although Partridge does not believe that the results presented at the conference should immediately alter current screening recommendations by the United States Preventive Services Task Force, which recommends biennial mammography starting at the age of 40 years, she noted that younger women who are at risk might benefit from earlier screening. 'We need to develop better tools for screening and better tools and communications to identify young people at high risk who warrant earlier screening,' she said in the interview.
For clinicians treating younger patients with breast can, Partridge emphasized the importance of personalized approaches: 'Carefully and tailored treatment is needed, targeting the tumor in consideration of the host, including issues unique to or accentuated by young age onset, such as fertility and genetics.'
Toriola concluded his presentation by outlining future research directions: 'We need to continue impactful research to ensure that there is a continued reduction in mortality and that we understand the biologic mechanisms driving incidence and response to treatment.'
Toriola and Partridge had no financial relationships to disclose.
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Transcript: Dr. Mehmet Oz on "Face the Nation with Margaret Brennan," Aug. 3, 2025
The following is the transcript of an interview with Dr. Mehmet Oz, Centers for Medicare & Medicaid Services administrator, that aired on "Face the Nation with Margaret Brennan" on Aug. 3, 2025. MARGARET BRENNAN: Change is coming for the country's Medicaid system as part of the enactment of the Big, Beautiful Bill. To help us understand what's ahead, we turn now to the Administrator of the Centers for Medicare and Medicaid Services, Dr. Mehmet Oz. Good morning. Welcome to Face The Nation. DR. MEHMET OZ: Thank you. MARGARET BRENNAN: You've got a lot of work ahead. I want to start on drug costs. The president put this 25% tariff on India, big drug producer. The President's trade deal with the EU puts a 15 percent tariff on imported medicines from Europe. How do you stop the drug makers from passing along those costs to people on Medicare and Medicaid? DR. MEHMET OZ: Well, the president's letter on Thursday for most favored nation pricing is a good example of that, and he's been working on this tirelessly since the first administration. And just to put this in context for many of the viewers, about two thirds of bankruptcies in America are caused by health care expenses. About a third of people when they go to the pharmacy, they leave empty handed. They can't afford the medication. So the President has said, Enough global freeloading. We've been covering much of the development costs for new drugs to cure cancer, deal with lots of other illnesses that are life threatening. It is in time for the American public to understand that we should not be paying three times more for the exact same medication in the same box, made in the same factories. The president's saying, equalize it out. Let's use a model that's worked, for example, for external threats, that's what NATO did. Everyone has to pay a little more. We'll pay extra too, but we won't pay a lot more than everybody else, so they actually have to raise their contributions, in this case, to an internal threat, which is illness. We'll pay a little less than America that way more Americans can afford these medications, and it's a fair system for the entire globe. MARGARET BRENNAN: So this was declared in these letters that were sent out to 17 pharmaceutical companies this past week, and it calls for extending that to Medicaid drug prices. Is that intended to offset what will be, you know, cuts to Medicaid? And do you know, you know, if the companies are actually going to follow through on this, like, how do you actually strong arm them into doing it? DR. OZ: Well just get the numbers correct. We're putting 200 billion more dollars into Medicaid. So we're actually investing— MARGARET BRENNAN: —by the time when costs are going up, so. DR. OZ: Costs are going up, but there's been a 50 percent increase in the cost of Medicaid over the last five years. So I'm trying to save this beautiful program, this noble effort, to help folks giving them a hand up. And as you probably gather, if Medicaid isn't able to take care of the people for whom it was designed, the young children, the dawn of their life, those are the twilight of their life, the seniors and those who are disabled living in the shadows, as Hubert Humphrey said, then we're not satisfying the fundamental obligation of a moral government. And this President has said over and over that he believes that it is the wise thing and the noble thing to help those who are vulnerable and every great society does that, we're going to as well. So we're going to invest in Medicaid as is required, but we want an appropriate return on that investment. One thing that Medicaid patients should not face are drug prices they can't afford. MARGARET BRENNAN: Right, how do you enforce this? Pharmaceutical companies— DR. OZ: Well, the pharmaceutical companies, if you sit them down quietly, Margaret, and we've done that, and say you went into this business at some point, because you cared about people. I know there's many out there shaking their heads, but that is actually the truth. People go into health care, whether they're pharmaceutical companies or insurance companies or the PBMs or anybody in the space. Even at the CMS, the most impressive thing to me in my new task, and the President has appointed me to, is the remarkable quality of people within the organization, just unbelievably talented. They went into this job because they care about health care and about people. Somewhere along the lines, people forget. They put numbers ahead of patients. And when that happens, then you start running into problems. We went to the pharmaceutical companies and we said, you appreciate this is not a fair system. We should not be paying more in America, three times more, for your products than you charge in Europe. They get the joke. They understand the reality of this problem. They are engaging with us. We're in the middle of those negotiations. The President has a unique power to convene. We've done it with dealing with prior authorization, this heinous process where patients feel like they're trying to get care from a doctor. Everything's being done except all of a sudden the arm of insurance comes in and stops the whole process for unknown reasons for weeks, sometimes months. The insurance companies, representing 80 percent of the American public, got together and they said, because we pushed them, we're going to deal with this. We can do the same, I believe, with the pharmaceutical industry, with most favored nation pricing. MARGARET BRENNAN: Let me ask you about the changes that are coming because of this new law to Medicaid, which is jointly administered between the feds and the states. There are major reduction- reductions to federal health care spending here, one of the changes are these work requirements. It's about 20 hours a week, volunteer or work to qualify for health care. What is the guidance you are giving to states on how to implement this? Because in this economy, things are more complicated. Uber driver, independent contractor, how do they show they work their 20 hours a week? DR. OZ: Last weekend, I was at the National Governors Association with Secretary Kennedy, who has been a big advocate of work as well. Every Democratic president and Republican president has said that the foundation of a healthy welfare system of a social system of support is work. MARGARET BRENNAN: Right, but I'm asking how you actually implement that and register it so that people who are working do qualify, and they don't get caught up in paperwork because they didn't file something on time. DR. OZ: As long as we're okay that people should work and would want to work, and it's not just work, it's community engagement. They can go get educated, right? They can take care of family members. They can contribute in other ways, but work is a great way of doing and get you out of poverty if you can find jobs and elevate yourself. There have been efforts to do this in the past, but they haven't been able to achieve what we can achieve, because we have technologies now. And we've invested already, as soon as the bill was signed, began pilots to try to demonstrate that we can actually do this correctly. We have pilots now in Louisiana and in Arizona, in both cases, within seven minutes, you can click on where you're working. You mentioned Uber, you're an Uber driver. You click that button on your phone. It just takes you to your payroll provider. Let's say it's ADP. We then ask your permission, can we connect with this payroll provider to demonstrate what you've actually been able to work and earn over the past month? This also, by the way, confirms your eligibility. But there's a bigger benefit here. Once you do that, you're in, you're done. However, what if we take one step further, Margaret? What if we go beyond just proving that you tried the work to actually say, You know what, you didn't work enough, but we can actually help you by connecting you through an employment office? MARGARET BRENNAN: So you're still figuring out the technology, but isn't there an end-of-December deadline for a lot of these things to be figured out? And how do you make sure that people don't get kicked off? Because in the state of Georgia, which already had work requirements, they have really struggled to make this work. DR. OZ: Well, a couple of things. It's not the end of December, it's end of December a year from now, and Georgia is apples and oranges. Georgia had a program only for people under the poverty level, and for those people, if they wanted, they could elect to come into a system to help them get jobs. There have been 50,000 reduction in head count of uninsured people in the overall program in the last five years. Overall, Georgia, 2 million less uninsured people. So Georgia is using a lot of tactics, and they're going in the right direction. I would argue that if you have confidence in the American people and their desire to take to offer to try to get a job, if we challenge you to that. And remember, if you're an able-bodied person on Medicaid, you're spending 6.1 hours watching television or leisure time, so you don't want that— MARGARET BRENNAN: —Well, KFF Health Policy found 92 percent of adult Medicaid recipients already are working. Or they have the carve out because they have to have caregivers, or they have to do other things. DR. OZ: They're fine. All they have to do is there'll be a simple app. If you've already carved out, that's super simple. If you're supposed to be if you're able-bodied and supposed to be working, we want to help connect you to the job market and get you into work. We have twice as many jobs available in America as people who seem to want them. The foundation of work is not just about fulfilling eligibility. The goal of health care insurance is to catalyze action in the right direction, to get you healthier, to give you agency over your future, so you recognize you matter, and you should have a job, therefore to go out and change the world. MARGARET BRENNAN: So there's a drug addiction problem in this country. How are those changes going to impact people who are on Medicaid in states like Kentucky, in states like West Virginia? DR. OZ: In many instances, there are carve outs for folks who have substance use disorder problems. There are programs-- MARGARET BRENNAN: —How do they prove that? ADMINISTRATOR OZ: Well, they can— MARGARET BRENNAN: Is this in the app? DR. OZ: Yes, it will be in the app. The app, again, this is being developed by the United States Digital Service, led by Amy Gleason, who is a wonderful technologist. She and I were with the President and Secretary Kennedy and the head of the czar for AI in this country on Wednesday, talking about overall how we're going to change the use of health technology in America. We've got to get into 2025 with health technology, as is true in every other sector. If you're watching the show right now, you could also be streaming media. You could take an Uber somewhere, the rideshare. You could do an Airbnb. Technology should make the system more efficient. We should have confidence that it will also allow us to do what we all agree is possible. If the whole challenge to a work requirement is that you don't have confidence in our ability to accomplish it, that's a separate question, because I do have confidence in the American people, and we have confidence we can pull this off. Look at the passport system, Margaret. Right now, you can go and get a passport in two weeks without having to go to the post office, send pictures, and all that's gone. It's fixable. Let's use technology. MARGARET BRENNAN: I'm still confused on how someone who is in the throes of substance abuse is going to use an app to say, I'm in the throes of substance abuse every week, to file on online— DR. OZ: —When they go in to get their help for their substance abuse treatment, assuming they're going for help on that, they can also get enrolled in, in those requirements, can be fulfilled. We want to talk to them in as many ways as possible. It's not going to happen just because we put an app out there, you, you have social workers and other folk elements who care a lot about this population, who are coming together, but they have to have some mechanism to report back. That just has not been done well. MARGARET BRENNAN: Well, and this is incredibly detailed, and that's why we wanted to have you on. I have so many more questions for you on rural hospitals and some of the other criticisms. I have to leave it there for now. But thank you, Dr. Oz-- DR. OZ: Can I give you 30 seconds on rural hospitals, because this is important. You have 7 percent of Medicaid money going to rural hospitals. We're putting 50 billion dollars the president wants us to, Congress wants to— MARGARET BRENNAN: There are a lot questions on how you're going to duel that out, and whether you have already made promises. Do you have any specifics for us? DR. OZ: Yes. Wait, wait, it's going to be, they'll get the applications in early September. The money is designed to help you with workforce development, right sizing the system and using technology to provide things like telehealth that can change the world. Imagine if we can change the way we think about the delivery of health and make it more about getting people healthy so they can thrive and flourish and be fully present in their own lives and as Americans. MARGARET BRENNAN: Dr Oz, we'll leave it there. We'll be back in a moment. Black swimmers teach others amid history of aquatic segregation How safe is our Social Security safety net? In Gaza, hunger forces impossible choices as Hamas releases propaganda video of hostage Solve the daily Crossword
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Dr. Oz touts investment in Medicaid: 'I'm trying to save this beautiful program'
Centers for Medicare and Medicaid Services (CMS) administrator Dr. Mehmet Oz says the Trump administration plans to invest more than $200 billion "more dollars" into Medicaid following the passage of the "One Big Beautiful Bill." "I'm trying to save this beautiful program, this noble effort, to help folks, giving them a hand up," Oz told CBS' "Face the Nation" on Sunday. "And as you probably gather, if Medicaid isn't able to take care of the people for whom it was designed, the young children, the dawn of their life, those who are twilight of their lives, the seniors, and those who were disabled living in the shadows, as Hubert Humphrey said, then we're not satisfying the fundamental obligation of a moral government," he continued. Oz, the 17th administrator for CMS, said the government wants "an appropriate return" on the Medicaid investment. He addressed the difference in drug costs between the U.S. and Europe, adding that work is being done by the administration in an attempt to bring drug prices down. Last week, the Trump administration announced it is launching a new program that will allow Americans to share personal health data and medical records across health systems and apps run by private tech companies, promising that this will make it easier to access health records and monitor wellness. CMS will be in charge of maintaining the system, and officials have said patients will need to opt in for the sharing of their medical records and data, which will be kept secure. Those officials said patients will benefit from a system that lets them quickly call up their own records without the hallmark difficulties, such as requiring the use of fax machines to share documents, that have prevented them from doing so in the past. "We're going to have remarkable advances in how consumers can use their own records," Oz said during the White House event. CMS already has troves of information on more than 140 million Americans who enroll in Medicare and Medicaid. Earlier this month, the federal agency agreed to hand over its massive database, including home addresses, to deportation officials.
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Needle-free vaccine method delivers antibodies through dental floss in early study
Dental floss could eventually do much more than improve oral hygiene. A new study led by Texas Tech University and the University of North Carolina suggests that the thin filament could eventually double as a vaccine mechanism. In animal models, the researchers showed that dental floss can effectively release vaccines through the tissue between the teeth and gums, according to a press release. In the study, the flossing technique triggered the production of antibodies in "mucosal surfaces," such as the lining of the nose and lungs, the release stated. The findings were published in the journal Nature Biomedical Engineering. "Mucosal surfaces are important, because they are a source of entry for pathogens, such as influenza and COVID," said co-author Harvinder Singh Gill, professor of chemical and biomolecular engineering at North Carolina State University, in the release. With the traditional method of injecting vaccines, the antibodies are primarily produced in the bloodstream, he noted. "But we know that when a vaccine is given via the mucosal surface, antibodies are stimulated not only in the bloodstream, but also on mucosal surfaces," said Gill. "This improves the body's ability to prevent infection, because there is an additional line of antibody defense before a pathogen enters the body." The vaccine enters through the "junctional epithelium," which is a thin layer of tissue in the deep pocket between the tooth and the gum. This tissue doesn't have the same barrier as other tissue linings, which means it can release immune cells into the body. In the study, the researchers added a peptide flu vaccine to unwaxed dental floss before flossing the teeth of lab mice, according to the release. Next, they compared the effectiveness of the floss-delivered vaccine to techniques that delivered it nasally or orally. "It would be easy to administer, and it addresses concerns many people have about being vaccinated with needles." "We found that applying vaccine via the junctional epithelium produces a far superior antibody response on mucosal surfaces than the current gold standard for vaccinating via the oral cavity, which involves placing vaccine under the tongue," said first author Rohan Ingrole, a Ph.D. student at Texas Tech University. "The flossing technique also provides comparable protection against the flu virus as compared to the vaccine being given via the nasal epithelium." In addition to flu, the test was repeated for three other vaccine types: proteins, inactivated viruses and mRNA. For all types, the flossing technique produced "robust antibody responses in the bloodstream and across mucosal surfaces," the release stated. Next, the research team aims to test the effectiveness of vaccine delivery to the epithelial junction in humans through the use of floss picks, which are easier to hold. "It would be easy to administer, and it addresses concerns many people have about being vaccinated with needles," Gill said. "And we think this technique should be comparable in price to other vaccine delivery techniques." Hua Wang, assistant professor of materials science and engineering at the University of Illinois' Grainger College of Engineering, was not involved in the study but shared his reaction to the findings. "This study presents a promising floss-based vaccination method that can avoid needle injection or any potentially painful procedure," he told Fox News Digital. "The authors demonstrated that vaccine components in the floss coating can penetrate the junctional epithelium in gingival sulcus and reach the underlying tissues, leading to systemic antibody responses." The floss-based vaccination method could help to improve patient compliance if it goes through the full evaluation process, he noted. There are some limitations and drawbacks associated with floss-based vaccines, the researchers acknowledged. Babies and toddlers who don't have teeth yet wouldn't be candidates for the technique, for example. "In addition, we would need to know more about how or whether this approach would work for people who have gum disease or other oral infections," Gill added. Wang agreed that many questions remain to be answered about this experimental vaccination method. "In addition to the unclear impact of gingival tissue infection on vaccination, the local and systemic side effects of this vaccination method remain to be understood," he told Fox News Digital. "For example, vaccination at the gingival tissue may initiate local inflammation that eventually induces undesirable side effects." It's also not yet clear what exact path the vaccine components follow when traveling from the tooth site to the tissues or how the immune responses are generated, Wang noted. For more Health articles, visit "Lastly, from the translation perspective, the efficacy of floss-based vaccines would need to be comparable to conventional needle-based vaccines." The study was funded by the National Institutes of Health (NIH) and by funds from the Whitacre Endowed Chair in Science and Engineering at Texas Tech University.
