The Women's Health Resource. On the web since 1997.

Elderly Women Need More Aggressive Breast Cancer Treatment (dateline December 1, 1999)

A recent study conducted at the Naval Medical Center in San Diego, California reveals that elderly women with breast cancer will benefit from aggressive treatment including chemotherapy or radiotherapy in conjunction with breast surgery. The study shows that some physicians believe that aggressive cancer therapy is riskier in older patients and that women over the age of 75 are more likely to die of another ailment related to old age, such as heart disease, before the effects of breast cancer become devastating. Therefore, many elderly women with breast cancer presently do not receive chemotherapy or radiation therapy.

The study followed 68 women with breast cancer at age 75 or older. After three years, 24 of the women had died. Though most of the deceased women also suffered from high blood pressure, heart disease, or diabetes, the researchers found that 58% of the women had died of breast cancer. When researchers reviewed the medical records of the 68 women, they discovered that only 64% of the women were given radiation therapy after lumpectomy (surgical removal of a cancerous breast lump and a margin of surrounding tissue). Physicians usually recommend that women who have breast-conserving therapy (lumpectomy) have at least six weeks of radiation therapy after surgery. In the United States, 80% of women who have lumpectomy also receive radiation treatment.

Researchers also found that only 17% of women with metastatic breast cancer who had mastectomy had received chemotherapy. (Metastatic breast cancer is cancer that has spread beyond the breast and underarm lymph nodes; mastectomy is the surgical removal of the affected breast). Chemotherapy is currently recommended to two-thirds of younger women with metastatic breast cancer as an aggressive treatment.

Results of the study were presented at the annual meeting of the Radiological Society of North American in Chicago. Radiologist Peter Johnstone, MD, who led the study, believes the 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. The study cautions medical experts to focus more on eliminating breast cancer in elderly women by using adjuvant (additional) therapies (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. 77% of women with breast cancer are over 50 years of age at the time of diagnosis while women ages 20 to 29 account for only 0.3% of all breast cancer cases. The American Cancer Society estimates that 10,000 women over age 80 will die of breast cancer in 1999. To help detect cancer at an early stage when it is more curable, women over forty should have a yearly screening mammogram in addition to a yearly clinical breast exam and monthly breast self-examination (BSE).

Additional Resources and References