Elizabeth M Nichols, Randi J Cohen, Sally B Cheston and Steven J Feigenberg
In 2013, breast cancer affected 232,340 women in the US. Of these diagnoses, 52% were in women aged 65 and older. Although age is a risk factor for the development of breast cancer, women diagnosed at an older age generally have a more favorable prognosis due to often less aggressive tumor biology. Elderly women tend to have higher rates of hormone receptor positive tumors and also tumors with lower proliferative indices (Ki-67). Despite these favorable prognostic factors, breast cancer specific mortality has only decreased at a rate of 1.1% per year for women aged 75+ in comparison to 2.4% per year for women aged <50. It has been hypothesized that this is related to under-treatment of elderly patients due to increased comorbidities which can limit treatment options as well as social influences such as distance to treatment facilities and lack of transportation. Older women are less likely to be offered standard treatment including surgery, radiotherapy, chemotherapy and endocrine therapy regardless of their breast cancer stage.
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