VANESSA TRUMP AND THE RISE OF EARLY-ONSET BREAST CANCER IN WOMEN UNDER 50
Newsweek Exclusive Feature
Vanessa Trump's diagnosis has put a famous face to a quiet epidemic; experts told Newsweek that young women should pay attention.
When Vanessa Trump, 48, revealed her breast cancer diagnosis on May 20, her comparatively young age was talked about less than anything else.
In recent years, we have grown accustomed to famous faces and people in our personal lives facing cancer at a much younger age. To understand why this is happening, Newsweek spoke with an oncologist and a cancer surgeon.
All this only deepens the alarm felt among oncologists about breast cancer no longer being a disease primarily experienced by older women. It is arriving earlier and doing so with a frequency that statistics are only beginning to fully capture.
The diagnosis of Vanessa Trump, ex-wife of Donald Trump Jr. and mother of five, follows that of Olivia Munn. The actress was diagnosed in 2023 at 42.
Australian singing sensation Kylie Minogue was diagnosed with breast cancer in 2005, at the height of her fame and at just 36.
Hollywood mainstay Angelina Jolie chose a preventive double mastectomy after testing positive for a cancer-causing gene mutation in her 30s. Her mother had died of cancer at 56.
And Olivia Newton-John, known for Grease, was first diagnosed with breast cancer when she was 44. She died in 2022 after her third bout of cancer spread.
Approximately 1 in 8 U.S. women will develop invasive breast cancer, according to the American Cancer Society.
It estimates that around 321,910 new cases of invasive breast cancer will be diagnosed this year alone. Invasive lobular breast cancer, a hormone receptor-positive form that is difficult to detect, has become the second-most-common type of the disease.
Cancer incidence rates in women under 50 are now 82 percent higher than in men, up sharply from 51 percent in 2002.
The concern has skyrocketed so much so that the Preventive Services Task Force (USPSTF) now recommends mammograms start at 40 instead of 50.
While incidence rates climb by over 1 percent per year, over the past four decades, the global number of people dying from cancer annually has doubled, with Black women disproportionately affected.
"Breast cancer is now the most common cancer among adolescents and young adults aged 15 to 39 and breast cancer among women under 50 is rising at 1.4 annually," Dr. Eleonora Teplinsky, Head of Breast and Gynecologic Medical Oncology at Valley Health System in New Jersey, told Newsweek. "This is not just due to better detection as most women under 40 are not being routinely screened with mammograms, so this is not all due to better detection.
"We don't fully know why breast cancer is on the rise and it is likely a combination of factors. Lifestyle changes over the past few decades—increased alcohol consumption, less physical activity, diets higher in processed foods, added sugar, and saturated and trans fats, and rising obesity rates are likely contributing."
She flagged that reproductive patterns have also shifted, with women are starting their periods earlier, having children later or not at all, and acknowledged industry questions around environmental exposures such as microplastics, endocrine-disrupting chemicals, PFAS or
"forever chemicals," air pollution, and proximity to Superfund sites.
"These things may play a role in breast cancer risk, but more research is needed," she said. "Compared to older women, younger women also tend to be diagnosed with more aggressive subtypes of breast cancer, which suggests there are real biological differences we still need to understand."
Cancer Is on the Rise
"I suspect part of the increase is simply that we are better at finding breast cancers," Dr. Daniel Landau, an oncologist, told Newsweek.
"Many women are now being screened at younger ages and imaging is better, awareness is higher, and women are being worked up earlier.
"Mammograms are better and advanced imaging like MRI is more widely available."
But Landau was careful to stress that improved detection, better technology and more celebrity names are not the full story.
"We're also seeing changes in lifestyle and environmental exposures that likely play a role—rising obesity rates, alcohol use, delayed childbirth, more-sedentary lifestyles, and probably a mix of hormonal factors we still don't fully understand," he said.
"Obesity is associated with higher estrogen, and higher estrogen may be associated with breast cancer.
"Also, history tells us that having children at a younger age is protective and many women are choosing to wait, but the frustrating part is that many younger women diagnosed with breast cancer do not have obvious risk factors at all."
Dr. Liz O'Riordan, a breast cancer surgeon who was diagnosed with both ductal and lobular cancer at 40, offered her own perspective.
"I'd had a few cysts in my thirties, and I thought that's what the lump was," she told Newsweek.
"But I had a mixed cancer—a ductal cancer that was the lump that disappeared during chemotherapy, but there was also 13 centimeters of lobular cancer in my breast that I couldn't feel."
On causes, O'Riordan was emphatic that screening technology alone cannot account for the rise in cancer among the young.
"It's not because better screening is picking up more cancers," she said.
"While some parts of the U.S. screen from the age of 40, breast cancer is happening in the 20- and 30-year-olds, and premenopausal women have dense breasts, which makes it harder to see breast cancer on a scan."
O'Riordan pointed to a new study from the U.K.'s Institute of Cancer Research and Imperial College London. It found that while rates of several cancers have been rising in younger adults, most established behavioral risk factors including smoking, alcohol, bad food and physical inactivity remained stable or declined before these diagnoses.
The researchers identified obesity, which has increased steadily since 1995, as a key factor, with the largest increases seen in younger women. Even so, the study concluded that rising BMI alone is insufficient to explain the rise.
As O'Riordan put it: "We don’t know for certain why breast cancer is rising in the under-50s, but we know that obesity is a factor.
"While this age group generally drinks less and moves more, the number of women who are overweight has steadily risen, and this is a risk factor.
"But we still don’t have the answer," she added.
The lack of a definitive answer may cause worry, but the picture is not uniformly dismal. Though diagnosis rates have skyrocketed, the cancer mortality rate has continued to decline, per the National Cancer Institute.
"Above all," added Teplinsky, who shares her insights online @drteplinsky. "We need more research on tumor biology in younger women and on the environmental and cultural factors driving these trends."
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