Older patients with breast cancer may be benefited by using radiation therapy for their tumors, a new study from University of Pennsylvania School Of Medicine in Philadelphia has revealed.
The researchers suggest that a breast cancer patient's age alone should not determine whether or not she receives standard breast-conservation treatments, including a lumpectomy and radiation therapy.
However, if additional health problems (comorbidities) are present, treatments should be individualized based on age and the type of comorbidities.
According to the National Cancer Institute's SEER Cancer Statistics Review, women between the ages of 75 and 79 have the highest incidence of breast cancer diagnoses at 497 cases per 100,000 people.
Along with cancer, most women in this age group were dealing with additional health problems.
The researchers sought to determine the impact of these additional medical problems on breast cancer patients who receive the same standard treatments as patients with no additional medical problems and if old age is a reason to deny some standard treatments.
Most randomised trials that compare outcomes of breast-conserving surgery with and without radiation consistently showed more positive outcomes when radiation was used.
Between 1979 and 2002, the researchers examined 238 women aged 70 and above, with Stage I or II invasive carcinoma of the breast and had received breast-conservation therapy. Their outcomes were compared by age groups and comorbidities. Most of the patients studied had mild comorbidities.
They found that the number of deaths from breast cancer among the patients was similar to the number seen among all age groups of patients without additional medical problems.
The researchers also found that the majority of elderly women with early-stage breast cancers and mild comorbidities actually benefited from the use of radiation and had minimal side effects.
The overall survival rates for the patients in the five- and 10-year follow-up periods were 80 percent and 50 percent.
"Doctors need to understand that comorbidities should be the determining factor in deciding an older patient's course of treatment, not age," said Dr Eleanor Harris, clinical director of radiation oncology at the Moffitt Cancer Center in Tampa, Fla.
"There is a sense in the field that elderly women need less treatment than younger women, but we should not be under treating women simply because they have passed the age of 70.
The study appears in the April 1 edition of the International Journal for Radiation Oncology*Biology*Physics, the official journal of the American Society for Therapeutic Radiology and Oncology.