Should a 90 year old get treatment for breast cancer


Our findings suggest that when treating breast cancer patients aged 90 years or older, it would be necessary to offer medical treatment considering the possibility of comorbidities and the complications associated with medical treatment. MeSH terms Aged, 80 and over

Older age increases the risk of several types of breast cancer. But advancements in diagnosis and highly individualized treatment plans are increasing the odds of recovery for older patients and making it possible for many to live longer, healthier lives.


Can you fight breast cancer at age 90?

print Dr. Mary Jo Tonelli, diagnosed with breast cancer at age 90, is choosing to fight it and remains active and in good health. Imagine being diagnosed with breast cancerat age 90 and choosing to undergo a double mastectomy and a five-year treatment to prevent recurrence.

What age is considered old age for breast cancer?

We define “old age” for purposes of this article as over 70 (with apologies to the young old who do not view themselves as elderly, and in fact, may be healthier and more vigorous than many people in their sixties). Approximately 24% of breast cancers in the U.S. are diagnosed in women aged 70 to 84 years.

Should older patients with breast cancer get surgery?

Tran says older patients — or anyone diagnosed with breast cancer — can benefit from getting care at a comprehensive center, such as the one where she performs surgery: the Sullivan Breast Center at Sibley Memorial Hospital in Washington, D.C.

Can you die from breast cancer at any age?

“Most patients treated for invasive breast cancer survive,” she says. “Even when you are diagnosed at an older age, you can successfully complete your therapy, go on living and eventually die from causes other than breast cancer.


Does breast cancer grow slower elderly?

Abstract. The incidence of breast cancer among women older than 65 years of age is 1.7 times higher than the rate for women 45 to 64 years of age, and 10 times higher than for women younger than 45.

How long can a 90 year old live with breast cancer?

Breast cancer incidence increases with age, peaking at age 80 [1]. Life expectancy has steadily increased. An 80 year old American woman has a life expectancy of 89 years, and a 90 year old woman has a life expectancy of 94.5 years [2].

Does age affect breast cancer survival?

The outcomes analysis showed that overall, women age 40 or younger when diagnosed were 30% more likely to die from breast cancer than women who were age 51 to 60 when diagnosed.

Should elderly get cancer treatment?

Depending on your age and general health, you might care more about feeling well than curing cancer permanently. This might be especially true if you have a chronic health condition or you feel that your quality of life is poor. But if you are very healthy and enjoy many activities, you might want aggressive treatment.

Can a 90 year old have chemotherapy?

Organ toxicities may be more problematic in the elderly, but in most tumours, the efficacy of chemotherapy is not age dependent. Chemotherapy, where indicated for advanced cancer, can therefore be safely and effectively used in selected elderly patients.

How is breast cancer treated in the elderly?

The SIOG task force concluded that women older than 70 years of age should be offered the same surgical options as younger women. Breast-conservation therapy (BCT), lumpectomy, axillary lymph node sampling, and postoperative RT are recommended as the standard of care for patients of all ages with early breast cancer.

What happens if I don’t get treatment for breast cancer?

This study is the first to quantify the impact of patient refusal of surgery on the survival of breast cancer. It clearly demonstrates that women who refuse surgery have a doubled risk to die of breast cancer, regardless of personal factors, tumor characteristics, stage, and nonsurgical treatment.

How long can you live with untreated breast cancer?

Median survival time of the 250 patients followed to death was 2.7 years. Actuarial 5- and 10-year survival rates for these patients with untreated breast cancer was 18.4% and 3.6%, respectively. For the amalgamated 1,022 patients, median survival time was 2.3 years.

What age is breast cancer most aggressive?

With treatment, the prognosis (chances of survival) for young women diagnosed with early breast cancer are good. However, prognosis tends to be worse for women under 40 than for older women. This is because breast cancers in younger women can be more aggressive than breast cancers in older women [221].

Is chemo hard on the elderly?

Chemotherapy and radiation therapy cause side effects more often and in greater severity to the elderly than to the young. Elderly patients also recover from treatments more slowly.

Is cancer less aggressive in older people?

The old idea that cancer is less aggressive in the elderly is not entirely without merit: breast and prostate cancers tend to grow more slowly in older patients. But other types—colon and bladder cancer and certain leukemias, for example—are usually more aggressive and harder to treat.

When should you not do chemotherapy?

Cancer treatment is at its most effective the first time that it’s used. If you’ve undergone three or more chemotherapy treatments for your cancer and the tumors continue to grow or spread, it may be time for you to consider stopping chemotherapy.

What is the life expectancy of untreated breast cancer?

Median survival time of the 250 patients followed to death was 2.7 years. Actuarial 5- and 10-year survival rates for these patients with untreated breast cancer was 18.4% and 3.6%, respectively. For the amalgamated 1,022 patients, median survival time was 2.3 years.

How fast does breast cancer spread?

On average, breast cancers double in size every 180 days, or about every 6 months. Still, the rate of growth for any specific cancer will depend on many factors.

How does breast cancer cause death?

The major causes of death included pulmonary insufficiency (26%), infection (24%), cardiac disease (15%), hepatic insufficiency (14%), hemorrhage (9%), central nervous system disease (9%), and hypercalcemia (3%). The most common cause of death was metastatic disease to various organs, accounting for 42% of all deaths.

How often is breast cancer fatal?

Breast Cancer Survival Rates The overall 5-year relative survival rate for breast cancer is 90%. This means 90 out of 100 women are alive 5 years after they’ve been diagnosed with breast cancer. The 10-year breast cancer relative survival rate is 84% (84 out of 100 women are alive after 10 years).

Common Breast Cancers in Older Adults

The most common cancer diagnosed in this age group is invasive ductal carcinoma, or IDC , followed by invasive lobular carcinoma (ILC) . These cancers arise in different tissues of the breast, but are treated in similar ways.

Individualized Breast Cancer Treatment for Older Adults

Tran says her group’s approach to dealing with breast cancer in patients of any age is highly individualized. “We recommend both the treatments and the order in which the patient will receive them, which is very important. For instance, radiation is not common before surgery, since it makes wound healing more difficult.”

Breast Cancer in Patients Age 70 and Older: Questions and Answers

In gauging which treatment might be best for an individual, Tran looks at the characteristics of the tumor. This can help identify tumors that are likely to respond to hormone-blocking therapy alone and those that may respond to other modes of treatment.

A Team Approach to Breast Cancer Treatment

Tran says older patients — or anyone diagnosed with breast cancer — can benefit from getting care at a comprehensive center, such as the one where she performs surgery: the Sullivan Breast Center at Sibley Memorial Hospital in Washington, D.C.

What are the characteristics of breast cancer?

Characteristics of breast cancer in older women. The biological characteristics of breast cancer appear to change with age. Estrogen receptor (ER) and HER2 expression tends to increase with advancing age, while proliferation markers decline.

How many women will have breast conserving surgery in 2020?

One 2020 European study of women diagnosed with breast cancer at age 89 or older reported that 48% of these patients underwent breast conserving surgery, 37% had a mastectomy, while 15% did not have any surgery.

How long does breast cancer last?

Women diagnosed with early stage disease survived a median of 50 months, whereas those who were found to have stage IV disease at diagnosis survived a median of 14 months. Most of the women did not receive any additional treatment after surgery (14% of this group experienced a relapse). The authors concluded that old women should not be under- or over-treated because of their age; rather they deserve tailored treatment based on their specific circumstances.

When should BRCA1 and BRCA2 be checked?

This implies that intensive breast screening of BRCA carriers should continue even after age 70.

Can a woman over 70 get chemo?

Increasing age has been found to be associated with higher breast cancer-specific mortality among postmenopausal women with ER+/PR+ breast cancer. Several studies have reported that women over 70 can often benefit from chemotherapy for aggressive disease. A 2021 study reported that women 65 and older who did not to receive chemotherapy, or who could not tolerate endocrine therapy ( tamoxifen or an aromatase inhibitor ), are at increased risk of recurrence if they also omit radiotherapy.

Can non-invasive breast cancer be treated?

Women with non-invasive breast cancer also could benefit from active treatment if they are otherwise reasonably healthy. One 2020 study reported that women over 65 with DCIS who were assigned to active surveillance had higher breast-cancer-specific mortality than women who were treated for the disease.

Should older women have breast MRIs?

This has led some observers to conclude that contralateral breast screening with breast MRIs should be considered in older women with newly diagnosed breast cancer. While most tumors in elderly women are indolent, aggressive breast cancer still does occur.

How many nursing home residents underwent breast cancer surgery?

Published in JAMA Surgery, it followed nearly 6,000 nursing home residents who underwent inpatient breast cancer surgery over a 10-year period.

What are the health problems women in nursing homes have?

The women in the study (average age 82) had high rates of diabetes, arthritis, heart failure and stroke. They needed considerable help with everyday tasks. Well over half were cognitively impaired.

Why isn’t mammogram recommended for women over 75?

The United States Preventive Services Task Force doesn’t recommend mammograms for women over 75 because there’s insufficient evidence to assess benefits and harms. Older women have largely been excluded from clinical trials.

How many false positives are there in breast cancer screening?

It explains procedures, helps women assess relevant health factors and points out that over age 75, screening 1,000 women prevents only one breast cancer death over 5 years, while generating 100 false positives. (There’s also a version for women over 85 .)

How many people die after lumpectomy?

Within a month after surgery, two to eight percent of the patients in the study had died, a very high mortality rate. Those undergoing lumpectomy — perhaps, the authors hypothesize, because those women were sicker and deemed less likely to survive more invasive surgery — were most likely to die.

Did Annie Krause get breast cancer?

As for her grandmother, Annie Krause, she declined the biopsy and Dr. Schonberg supported her decision. “In a 98-year-old, it probably is breast cancer,” Dr. Schonberg said. “But she didn’t want any more medical interventions. She was focused on optimizing her quality of life.”.

Where is Annie Krause?

By Paula Span. Sept. 14, 2018. Annie Krause moved into a nursing home in Detroit in 2015, when she was 98 years old. She had grown frail. Arthritis, recurrent infections and hypertension had made it difficult for her to manage on her own. When the facility’s doctor examined her, he found a mass in Ms.

What do you see happening next in the field of geriatric oncology?

My hope is that the trend toward making older patients part of clinical trials — or sometimes even the focus of a study — will continue. For decades, these patients have been excluded for reasons ranging from fear that their bodies won’t be able to handle toxic treatments to lack of social support and ageism. Exclusion from clinical trials is one of the reasons we have so little data to make confident, evidence-based decisions for our older cancer patients.

What is a geriatric service meeting?

Members of the Geriatric Service meet regularly to discuss what’s appropriate for each person. It’s the very definition of individualized treatment.

What do social workers do to help with cancer?

Social workers with psychological training assist with everything from emotional counseling to nutrition advice and guidance in setting up transportation for follow-up appointments. They also look for ways to ease the strain on spouses and other caregivers. All this makes a difference when it comes to older people being able to handle treatment that will truly help them overcome cancer.

Who is Stuart Lichtman?

According to Memorial Sloan Kettering medical oncologist Stuart Lichtman, a longtime specialist in caring for older cancer patients, it wasn’t clear to doctors whether these patients should be treated differently in any way.

Do you have to wear a mask at MSK?

Masks Are Still Required at MSK. Patients and visitors must continue to wear masks while at MSK, including people who are fully vaccinated. MSK is offering COVID-19 vaccines to all patients age 12 and over. To schedule or learn more, read this. News & Information /.

Is performance status adequate for older patients?

Another major insight is that traditional measures of “performance status” that predict how well a person is likely to withstand the rigors of chemotherapy, surgery, and other forms of cancer treatment are not adequate for older patients.

Is there a way to treat cancer in 2014?

The good news is that in 2014 there are often options available for avoiding or minimizing drug interactions. And increasingly, there are ways of treating cancer in people at varying levels of overall health and function.

How long does breast cancer last?

Metastatic breast cancer remains incurable, regardless of age. About 20% of patients with metastases survive 5 years, but major differences in survival depend on tumor phenotype, disease-free interval, disease site, and number and volume of metastases.

What is the best treatment for metastatic cancer in elderly?

For patients age 80 years and older who have not had adjuvant endocrine therapy or who completed adjuvant endocrine therapy > 1 year before the detection of metastatic disease, we recommend the start of treatment with an aromatase inhibitor as opposed to tamoxifen in view of the more favorable toxicity profile of aromatase inhibitors in elderly patients (lack of endometrial cancer or thromboembolic risk). Recent data have suggested that the addition of palbociclib, an oral cyclin-dependent kinase inhibitor, to endocrine therapy can substantially increase progression-free survival compared with endocrine therapy alone when used as first-line therapy for metastases. 63 For second-line therapy, both palbociclib and everolimus added to endocrine therapy can substantially improve progression-free intervals compared with endocrine therapy alone 64, 65; however, data are limited about the toxicity profiles of these agents in older patients, and no convincing evidence as yet shows that these biologic agents improve survival. Endocrine therapy should be the treatment of choice in these patients and should be continued until the patient’s condition is clearly refractory to treatment.

What are the three phenotypes of breast cancer?

The three major phenotypes are hormone receptor (HR; estrogen and/or progesterone receptor) positive and human epidermal growth factor receptor 2 (HER2) negative, HR negative and HER2 negative (so-called triple negative), and HER2 positive (with any receptor status). Characteristics of these three phenotypes are shown in Table 2. At least 75% of patients age 80 years and older will present with HR-positive and HER2-negative tumors, whereas more aggressive triple-negative and HER2-positive lesions account for the remainder. 40

What is the life expectancy of a human HER2 positive tumor?

Chemotherapy and anti-HER2–directed therapy only for those with estimated non–breast cancer–related life expectancy of > 5 years and improvement in survival of at least 3% at 5 years. Abbreviations: HER2, human epidermal growth factor receptor 2; HR, hormone receptor.

How common is breast cancer?

Breast cancer is the most common cancer in women, with an incidence that rises dramatically with age. The average age at diagnosis of breast cancer is 61 years, and the majority of woman who die of breast cancer are age 65 years and older. Major improvements in public health and medical care have resulted in dramatic increases in longevity. The oldest old (those age 80 years and older) are a rapidly expanding group and now comprise 9 million members of the US population. The treatment of individuals who are age 80 years and older is complex and involves clearly defining the goals and value of treatment while also weighing risks, such as the potential effects of treatment on functional loss and quality of life. Limited evidence-based treatment guidelines exist for the caring of this older cohort of patients with breast cancer. Data from clinical trials that enroll primarily younger patients lack the information needed to estimate the likelihood of toxicities that can be life changing in older adults. Clinicians who make treatment recommendations should place the available evidence in the context of the patient’s life expectancy and geriatric assessment results that include an evaluation of a patient’s functional status, comorbidities, cognition, social support, nutritional status, and psychological state. Furthermore, these decisions should be placed in the context of the patient’s goals for treatment, preferences, and values. This review summarizes the current literature and focuses on the role of geriatric assessment in treatment recommendations for patients age 80 years and older with early and metastatic breast cancer.

What is the best value for chemo?

The best value of chemotherapy will be in older patients with HR-negative tumors where the majority of relapses occur < 5 years from diagnosis. 56 The following are some general guidelines we consider, but the decision is individualized by taking into account the patient’s preferences. For patients age 80 years and older with life expectancies of at least 5 years and similar to the 10-year recommendations for all ages in PREDICT, 57 we do not recommend adjuvant chemotherapy for an absolute survival benefit of < 3% at 5 years, would consider chemotherapy for an absolute survival of 3% to 5%, and recommend chemotherapy for an absolute survival benefit of > 5%. For patients offered chemotherapy, we favor nonanthracycline second-generation regimens unless third-generation regimens (those that include anthracyclines and taxanes) improve 5-year absolute survival by > 3% compared with second-generation regimens. For patients with HER2-positive tumors, similar absolute survival benefits should be considered before offering chemotherapy and trastuzumab.

What are the toxicity considerations for chemotherapy?

The major toxicity considerations are for patients who receive chemotherapy. Models that predict grade 3 and greater toxicity can help in the chemotherapy treatment decision. 19, 58 The careful review of potential toxicity, such as neuropathy (taxanes), decreased ejection fraction and congestive heart failure (anthracyclines, trastuzumab), and myelodysplasia and acute leukemia (anthracyclines), is a key part of decision making. Cardiac function should be measured before anthracycline and/or trastuzumab administration and during trastuzumab therapy. In addition, the potential for hospitalization secondary to chemotherapy treatment adverse effects should be considered. In one study, hospitalization for toxicity occurred in 13%, 24%, and about 20% of patients age 65 years and older treated with docetaxel and cyclophosphamide; docetaxel, doxorubicin, cyclophosphamide; and anthracycline/taxane regimens, respectively. 59 These percentages almost certainly would be higher in women age 80 years and older. These hospitalization data need to be strongly considered because hospitalization of older patients frequently is associated with functional decline and shortened survival. 60

46 Answers

What, if any, symptoms is he suffering from? IMO, “suffering” is the key here. Plenty of cancers go on and on with no pain.
GF is 90. If he’s in no pain, I’d leave it alone. I’ve seen many seniors die from the treatments, before the cancer itself killed them.
The treatments can be so horrible for them.

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