Older doesn t mean less likely to benefit from breast cancer treatments

It s a common perception that breast cancer is deadlier among younger women, but women over 75 are actually more likely to die from the disease, according to a large international study.

The notion that breast cancer results in a higher rate of mortality in younger women stems from the fact that women under 65 are more likely than older women to have receptor-negative breast cancer, which is faster-growing and less susceptible to most treatments than the more common receptor-positive type. Younger women are also more likely to be diagnosed at a later stage, furthering the perception that cancer is deadlier for them.

However, the latest study, published in the current issue of the Journal of the American Medical Association, tracked nearly 10,000 post-menopausal women who had been diagnosed with hormone receptor-positive breast cancer, and it was not at all the case that mortality was higher in younger women. Researchers actually found that women over 75 years-old were 63 percent more likely to die from this cancer than were women under the age of 65.

The disparity, say medical experts, is most likely due to a difference in treatment. And, in fact, the study bears this out: Although nearly all the women in the study underwent surgery, only half of those over age 75 received radiation therapy, and just 5 percent had chemotherapy. The less aggressive treatment in the older women most likely resulted from the belief that older women are less likely to benefit from chemotherapy and more likely to suffer from the side effects.

However, Dr. Hyman Muss of the University of North Carolina s School of Medicine says this will not be true of all older women. Dr. Muss (who was not affiliated with the study) noted that, while it s possible to overtreat older patients, otherwise healthy women in their 70s are likely to benefit from chemotherapy. We need to teach doctors not to think of a person s chronological age, but think of their functional age, he said. ACSH's Dr. Gilbert Ross very much agrees with Dr. Muss s assessment of the problem. It s the individual s overall health that should be taken into account, he says, not solely what you d expect to see in her age group.