Women over age 66 with metastatic breast cancer don't always get the full range of post-mastectomy treatments. A study done at MD Anderson Cancer Center in Houston showed that almost half of all senior women with advanced breast disease do not get radiation therapy after their surgery.
The researchers sifted through data from 38,000 women older than 66 who had a mastectomy between 1999 and 2005. In the group that was studied, 8,000 patients had metastatic breast cancer, but fewer than 4,000 had radiation in addition to surgery. Guidelines recommending that radiation be offered to women with advanced disease after a mastectomy were published during the six years that this study covered. So experts recognized the benefits of radiation for breast cancer, even after a breast is removed - remember that the chest wall and lymph nodes may be affected - but many women didn't get the additional treatment. Dr. Benjamin Smith, a co-author on this study, considered the possible reasons behind these results.
Many patients may have been offered radiation, but decided not to take it. Before the guidelines were published, most oncologists considered radiation to be ineffective after a mastectomy. So a historical prejudice against post-mastectomy radiation may have stood in the way of additional treatment for some women. In other cases, women who were over 80 years old seemed to be least likely to take radiation after breast surgery. These patients may considered the tradeoffs between quality of life and longevity, and decided that life during six or more weeks of radiation - plus recovery time - did not seem like their best choice. The women may not have lived within close distance to a radiation clinic, so driving or staying in a hotel during treatment may have not been an option. Cost of treatments and access to health insurance could also be a factor.
If you were age 66 or older at diagnosis, would you want the full range of treatments for advanced breast cancer? Or would you prefer to stick with the basic surgery and chemotherapy that many patients opt for? What would influence your decision? Please leave your comments below.