A recent study finds that elderly breast cancer patients who ha Elderly More Satisfied With Breast-Conserving Surgery Than Mastectomy (dateline October 9, 2003) | Breast Health News | Imaginis - The Women's Health & Wellness Resource Network

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Elderly More Satisfied With Breast-Conserving Surgery Than Mastectomy (dateline October 9, 2003)

A recent study finds that elderly breast cancer patients who had breast conserving surgery (lumpectomy) were more likely to report a better quality of life than patients who had their entire breasts removed with a mastectomy procedure. Despite findings of previous studies which show that chances of surviving early stage breast cancer are equal, regardless of which type of breast cancer surgery patients undergo, elderly patients are still more likely to be undergo mastectomy operations. The current study shows that a more complicated surgery such as mastectomy is not usually necessary for these patients.

To conduct their study, Dr. J. C. J. M de Haes, of the Academic Medical Hospital in Amsterdam, The Netherlands and colleagues gave quality of life questionnaires to elderly patients (average age: 70) who had either underwent breast-conserving surgery, in which only the breast cancer tumor and a surrounding margin of normal tissue is removed, or mastectomy, in which the entire breast is removed. The researchers asked the women about several issues, including: fatigue, emotional functioning, fear of recurrence, social support, physical functioning, and leisure time activities.

While the study did not show any difference in terms of survival based on the type of surgery the women had, Dr. de Haes and colleagues did find that women who underwent breast-conserving surgery were less likely to experience arm pain and tended to see themselves as having a better body image, compared to women who underwent mastectomy. Thus, the researchers conclude that breast-conserving surgery is a viable option for most elderly breast cancer patients with early-stage breast cancer.

The women who had breast-conserving surgery were also given the drug tamoxifen after surgery.

Tamoxifen, brand name Nolvadex, has been used for more than a quarter century to treat breast cancer and reduce the risk that the disease will recur. Because tamoxifen is associated with a number of side effects, most notably hot flashes but also blood clots and increased risk of stroke, physicians may be more weary of prescribing the drug to very elderly women. Physicians may also feel that very elderly breast cancer patients are unlikely to live long enough to benefit from taking tamoxifen.

Previous studies have found that elderly breast cancer patients are often not treated aggressively enough with adjuvant (additional) therapies, such as chemotherapy, radiation, or tamoxifen in addition to their surgery. Some physicians believe that aggressive cancer therapy is riskier in older patients and that women over the age of 75 are more likely to die of another ailment related to old age, such as heart disease, before the effects of breast cancer become devastating. However, the American Cancer Society estimates that approximately 10,000 women over age 80 will die of breast cancer this year.

Age is one of the leading risk factors for breast cancer. As a woman increases in age, her risk of breast cancer also increases; seventy-seven percent of women with breast cancer are over 50 years of age at the time of diagnosis while women ages 20 to 29 account for only 0.3% of all breast cancer cases.

To help detect cancer at an early stage when it can be more easily and successfully treated, the American Cancer Society, the American Medical Association, the American College of Radiology, and other several healthcare organizations and associations recommend that all women begin receiving regular mammograms once they reach 40 years of age, in addition to practicing monthly breast self-exams and receiving annual clinical breast exams.

Additional Resources and References

  • The report, "Quality Of Life In Breast Cancer Patients Aged Over 70 Years, Participating in the EORTC 10850 Randomised Clinical Trial," is published in the May 2003 edition of The European Journal of Cancer (Vol. 39, Issue 7), http://www.medicinedirect.com/journal/journal?sdid=5024