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Washington, D.C. — Women over age 80 with early stage breast cancer sometimes do not get a full range of treatments, even after considering their health and treatment preferences, according to a new study funded by the Agency for Healthcare Research and Quality (AHRQ). Interestingly, older womens' preferences were important factors in predicting treatment patterns for this age group. For example, body image was important to nearly three quarters of older women (> 67 years), and affected whether women received a mastectomy, removing the entire breast, or lumpectomy, where just the tumor was removed. This study, conducted by the Lombardi Cancer Center, Georgetown University Medical Center, Washington, D.C. and researchers at 29 hospitals across the country, is being published Tuesday, August 1, in the
Cancer Journal.
Women 80 years and older also were less likely to be referred to a radiation oncologist, according to the study. After breast conserving therapy, women over 80 years were more than three times more likely not to receive radiation therapy. The study also found that older black women tended to be less likely than older white women to receive radiation after lumpectomy. Researchers note that while the sample of black women was fairly small, this finding of differences in breast cancer treatment patterns by race is consistent with other research. The risk of cancer recurrence approaches 40% within 10 years when radiation is not given after a lumpectomy, well within the life expectancy for most older women.
This is one of the first large studies of breast cancer treatment to focus on the older woman that includes a defined stage of the disease and detailed information about patient, clinical, physician, and other factors affecting treatment patterns. Future research is needed to determine the appropriate clinical approach to treating breast cancer in the very old, and to include the under-represented older population in future clinical trials.
Details are in the August 1,
Cancer journal article: "Patterns of Breast Carcinoma Treatment in Older Women: Patient Preference and Clinical and Physician Influences" by Jeanne S. Mandelblatt, M.D., M.P.H.; Jack Hadley, Ph.D.; Jon F. Kerner, Ph.D.; Kevin A. Schulman, M.D.; and others.
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