Older women less likely to receive post-op therapy

Invasive breast cancer is the second leading cause of cancer death in older women. Yet, a recent study by researchers at the Massey Cancer Center at Virginia Commonwealth University in Richmond found that the older women become, the less likely they are to receive chemotherapy or radiation treatment after breast surgery to prevent cancer recurrence. In addition, the study found that older women are less likely to have axillary lymph nodes assessed to determine how far their cancer has spread.

Researchers examined the patterns of initial breast surgery (such as forms of mastectomy and breast-conserving surgery), cancer stage, and adjuvant therapy for 3,361 women with local and regional breast cancer listed in the Virginia cancer registry from 1985 to 1989. They linked the data to Medicare claims and census data for the same years. Study findings include the following:

• Use of chemotherapy declined by more than 60% per decade of age.

• Radiation therapy declined from more than 60% for women ages 65 to 69 to only 7% of women ages 85 and older.

• The probability that a woman would not receive an axillary lymph node assessment increased 2.5 times for every decade of age.

Comorbidities common in the elderly may prevent physicians from treating breast cancer more aggressively in older women, the study noted.

(See: Hillner BE, Penberthy L, Desch CE, et al. Variations in staging and treatment of local and regional breast cancer in the elderly. Breast Cancer Res Treat 1996; 40:75-86.)