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Older Women Lag In Breast Cancer Survival

November 14, 2011
Written by: , Filed in: Breast Imaging
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Survival rates for older women with breast cancer—75 or older—lag behind those for younger women, according to a new study conducted by The University of Texas MD Anderson Cancer Center in Houston.

Why? The study doesn’t say, though its lead author has some ideas.

The study was published online last week in the Journal of Clinical Oncology. It also found that black women with breast cancer are not seeing the same improvement in outcomes as white women. In 2006, the absolute death rate for black women with breast cancer was 38 percent higher than that for white women.

Benjamin Smith, MD, lead author of the study, summarized the conclusions thus:

We found that the oldest women, regardless of their race, and blacks, regardless of their age, are not benefiting as much from improvements in breast cancer treatments.

Dr. Smith is an assistant professor in MD Anderson’s radiation oncology department. He was quoted in an MD Anderson news release.

The study used data for 1980–2007 from the National Vital Statistics Reports, published by the Centers for Disease Control and Prevention, and for 1980–1997 from the Surveillance, Epidemiology, and End Results (SEER) registry, compiled by the National Cancer Institute.

Survival rates for older women with breast cancer lag behind those of their younger counterparts in several different measures. For example, the researchers found that from 1990 through 2007, the rate of breast cancer death decreased by 2.5 percent per year for women age 29 to 49, 2.1 percent per year for women 50 to 64, 2.0 percent per year for women 65 to 74, and 1.1 percent per year for women 75 or older.

The study said more research was needed to determine why older women are not benefiting as much from reductions in survival rates. Dr. Smith speculated that contributing factors might include lower mammography rates in that age group, limited knowledge of optimal treatments resulting from underrepresentation in or exclusion from clinical trials, and the limited utility of chemotherapy, because of its toxicity, among those who are older and more frail.

The American Cancer Society says more than 230,000 women will be diagnosed with breast cancer this year. Of those, 40,000 will be 75 or older—which, as the study points out, makes that the fastest-growing segment of the breast cancer population.

Neither the study nor Dr. Smith says this, but the question of treatment for such an older demographic segment—for breast cancer or anything else—is likely to get tangled up in debates over the costs of health care, and in particular Medicare. As with pretty much everything in health care these days, health care itself is not the only consideration.

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