Breast cancer in young women tends to be associated with genetic mutations including BRCA1 and BRCA2. The tumours are more likely to be poorly differentiated, hormone receptor negative and demonstrate lymphovascular invasion. Mammography is less sensitive in younger women due to the higher breast parenchymal density. Breast cancer in young women can mimic benign disease and triple assessment including core biopsy is essential to make the diagnosis. Breast MRI adds valuable information with accurate assessment of disease extent and evaluation of response to neoadjuvant chemotherapy.