A new study presented at the San Antonio Breast Cancer Symposium by researchers from the University of California, San Francisco (UCSF) and UC Davis Health highlighted that women aged 75 and older disproportionately account for breast cancer deaths. Analyzing data from the Surveillance, Epidemiology, and End Results (SEER) Program from 2000 to 2019, the study found this age group represents 36% of all breast cancer fatalities, despite comprising only 20% of diagnoses. Dr. Laura Esserman, a professor of surgery and director of the UCSF Breast Care Center, emphasized that older women are often overlooked in research and clinical trials, leading to a lack of tailored care.
The research indicates that older women are more prone to developing estrogen receptor-positive (ER-positive) breast cancers, which tend to be less aggressive but can recur late. Current screening guidelines often recommend discontinuing mammograms after age 75 or 80, particularly for those with a life expectancy under 10 years, a prediction doctors find difficult to make. This can lead to both overtreatment and undertreatment, with Dr. Esserman noting that older patients might receive excessive treatment for low-risk cancers or insufficient treatment for aggressive ones due to a focus on comorbidities and a reluctance to screen.
Dr. Elizabeth Morris, chair of radiology at UC Davis Health, suggested personalized approaches are needed, including better risk assessment tools for older women to determine who would benefit most from continued screening. Both Dr. Morris and Dr. Tina Hieken, a breast surgeon at Mayo Clinic, underscored the importance of robust communication between doctors and older patients about potential benefits and risks. The study implicitly calls for updated guidelines and potentially randomized trials to investigate effective screening and treatment strategies specifically for this 'forgotten population' of older women with breast cancer.
