Women diagnosed with breast cancer at a younger age often have concerns less frequently faced by older women. A cross-sectional survey of 204 women diagnosed with breast cancer at age 50 or younger within the past 3.5 years was conducted to examine issues particularly faced by younger women. The questionnaire included standardized measures of problems related to breast cancer (CARES) and open-ended questions asking women about their experiences. Concerns about premature menopause and pregnancy related issues, among those women for whom these issues were applicable, had the highest ratings as problems experienced by women since their diagnosis. Among all women, sexual functioning was a greater problem than lack of sexual interest, and body image was of moderate concern. Overall, relationships with partners were not a problem. In multivariate analyses, having a mastectomy was associated with greater problems with body image and interest in sex. Chemotherapy was associated with greater sexual dysfunction. Responses to open-ended questions were particularly informative and reflected the diversity of responses women have to breast cancer. Findings reinforce the need to develop interventions to help women deal with premature menopause and problems with sexual functioning following chemotherapy.