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Elderly Women Do Not Receive Aggressive Breast Cancer Treatment (dateline August 3, 2000)

Several recent studies reveal that elderly women with breast cancer are not offered aggressive treatments such as chemotherapy or radiation in addition to breast cancer surgery.  Some physicians believe that aggressive cancer therapy is riskier in older patients and that very elderly women (over age 80) are more likely to die of another ailment related to old age, such as heart disease , before the effects of breast cancer become devastating.  However, the American Cancer Society estimates that approximately 10,000 women over age 80 will die of breast cancer each year.   

In a study conducted at 29 hospitals across the United States, researchers studied 718 women 67 years of age or older with breast cancer.  Dr. Jeanne S. Mandelblatt of Georgetown University School of Medicine and her colleagues found that those women over age 80 were less likely to be recommended for radiation therapy than the women between 67 and 79 years of age. 

Furthermore, among those women who had breast-conserving surgery ( lumpectomy) for their cancer, the women over age 80 were 70% less likely to receive chemotherapy than younger patients and were 3.4 times less likely to receive radiation after lumpectomy.  Since the average risk of breast cancer recurrence (return) is 40% within 10 years of breast-conserving surgery in post-menopausal women, the researchers were surprised to find that many elderly women do not receive chemotherapy or radiation therapy in addition to breast cancer surgery.

In a previous study that was present at the annual meeting of the Radiological Society of North America (RSNA) in November 1999, researchers followed 68 women with breast cancer who were 75 or older.  After three years, 24 of the 68 women had died.  Though most of the deceased women also suffered from high blood pressure, heart disease, or diabetes, the researchers found that over half of the women had died of breast cancer. When researchers reviewed the medical records of the 68 women, they the majority of the women did not receive radiation therapy after breast-conserving surgery.   Radiation therapy helps destroy any remaining cancer cells after surgery, reducing the likelihood that cancer will return. 

At the RSNA meeting, radiologist Peter Johnstone, MD said these findings affirm the misconceptions that aggressive cancer therapy is riskier in older patients and that elderly women are likely to die of other diseases before breast cancer progresses.  These studies caution medical experts to focus more on eliminating breast cancer in elderly women by using additional therapies (such as radiation or chemotherapy) before or after breast surgery.

Age is one of the leading risk factors for breast cancer. As a woman increases in age, her risk of breast cancer also increases. Approximately 77% of women with breast cancer are over 50 years of age at the time of diagnosis while women in their twenties account for only 0.3% of all breast cancer cases. 

To help detect cancer at an early stage when it is more easily and successfully treated, the American Cancer Society, the American Medical Association, the American College of Radiology, and other several healthcare organizations and associations recommend that all women begin receiving annual screening mammograms once they reach 40 years of age, in addition to practicing monthly breast self-exams and receiving annual clinical breast exams.

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