OBJECTIVES:   There are no studies in the United States examining the trends in mortality rates, years of potential life lost (YPLL), and value of productivity losses due to breast cancer (BC) among women aged 20-49 years. We examined the trends in BC mortality rates by geographic region, estimated YPLL and value of productivity losses by race/ethnicity. METHODS:   National mortality data from 1970-2008 were used to calculate age-adjusted mortality rates and rate ratios (RRs). Joinpoint regression analysis was used to assess changes in trends over time. The YPLL were calculated to quantify the burden of premature mortality. The value of lost lifetime productivity earnings of young women who died of BC in 2008 were used to quantify the expected future value of lost productivity due to premature mortality. RESULTS:  From 1970 through 2008 the age-adjusted mortality rate from BC among white young women was 11.45/100,000 and 17.97/100,000 among blacks. Compared with whites, blacks had substantial higher age-adjusted breast cancer mortality rates. BC mortality rates vary by geographic region. The decline in BC mortality rates among blacks has been small (-0.68% per year) compared with whites (-2.02% per year). During the same period, the total number of deaths associated with BC in young women was 225,866, which accounted for an estimated 7.98 million YPLL. The estimated total productivity losses attributed to BC in young women who died in 2008 was $5.49 billion. On average, a young woman who died from BC in 2008 would lose $1.10 million in forgone lifetime earnings. CONCLUSIONS: Although blacks have substantially higher age-adjusted BC mortality rates, there has been very little overall change in death rates over time compared to other races.  Our results may implicate the need for focused attention to racial disparities in BC diagnosis, treatment, and survivorship efforts among specific populations.