Women Older Than 65 Have Worse Outcomes After Breast Cancer Diagnosis
- Tags:Progesterone-Receptor Positive, Estrogen-Receptor Positive, Ductal Carcinoma In Situ, Invasive or Infiltrating Ductal Carcinoma, Invasive or Infiltrating Lobular Carcinoma, Luminal A Breast Cancer, Luminal B Breast Cancer, 65 and older, Early-stage: Stage 0 — DCIS , Early-stage: Stage IA, Early-stage: Stage IB, Early-stage: Stage IIA, Early-stage: Stage IIB, and Early-stage: Stage IIIA
A large study has found that women older than 65 diagnosed with early-stage, hormone-receptor-positive breast cancer had worse outcomes than younger women with similar diagnoses. The research was published in the Feb. 15, 2012 issue of the Journal of the American Medical Association.
Nearly 9,800 women participated in the TEAM trial:
- 1,357 were 75 or older
- 3,060 were age 65 to 74
- 5,349 were younger than 65
All the women were diagnosed with early-stage, hormone-receptor-positive breast cancer. All had surgery to remove the cancer and then got hormonal therapy according to the study’s protocol. Some of the women got other treatments, such as radiation therapy and chemotherapy, as directed by their doctors. The women were followed for different periods of time after diagnosis. Half were followed for more than 5 years and the other half were followed for fewer than 5 years.
Older women were more likely to die during the study’s follow-up period. By age range, the proportion of women who died from breast cancer was:
- 8.3% 75 or older
- 6.3% age 65 to 74
- 5.7% younger than 65
Breast Cancer Treatment In Teens
Treatment for breast cancer in teens depends on how far the disease has spread and the teens general health and personal circumstances. All of these factors play an important role in what steps are taken. Some of the treatment options include:;
- Surgery In these cases, a lumpectomy or mastectomy is conducted. A lumpectomy includes the removal of the tumor and surrounding tissue. A mastectomy involves the removal of the whole breast. Depending on how far the disease has spread, either option may be best.;
- Radiation This therapy is usually used following a lumpectomy. Using cancer-killing beams, radiation therapy targets undetected cancer cells further reducing the risk of cancer returning.;
- Hormone This therapy is effective for those breast cancers that are affected by hormones in the blood. It utilizes drugs that block estrogen and/or progesterone.;
- Chemotherapy This is usually administered after breast surgery but before radiation, and uses drugs directly injected into the vein via a needle or pill to target and kill cancer cells.;
A Word Of Caution Regarding Home Genetic Tests For Breast Cancer
The idea of a home genetic test for breast cancer is exciting to many people, as these tests might help them avoid the clinic while being their own advocate in their health. It’s important to thoroughly understand the limitations of these tests, however, if you choose to do one.
For example, a popular at-home genetic test identifies three breast cancer genes that are more common among Ashkenazi women but are rare in other ethnic populations. While the company is transparent in admitting that the test only checks for 3 out of a potential 1000 BRCA mutations, not everyone reads the small print. The bottom line on this test is that for Ashkenazi Jewish woman, a positive test might let them know they should see their doctor . For most women the test is relatively meaningless, and actually be harmful if they trusted the results and did not have formal testing.
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Your Personal History Of Breast Cancer
If youve been diagnosed with breast cancer in the past, you are more likely to develop a new cancer in the other breast or in another part of the same breast. This is not considered a recurrence but a new breast cancer.
What to do: Follow your cancer teams instructions on monitoring to stay on top of this risk. Ask your doctor whether you should see a genetic counselor.
Breast Cancer And Teenage Girls
If youre a teenage girl, you might be worried about your risk of getting breast cancer.
Developing breast cancer when youre a teenager is extremely rare. Its also uncommon in women in their 20s and 30s. The vast majority of breast cancers are diagnosed in women over the age of 50.
There can be a lot of unreliable information and scare stories on the internet, so its important to use reputable websites or talk to your GP if youre worried about any changes to your breasts. You can also call our Helpline free on 0808 800 6000 to speak with one of our experts.
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‘i Had Fevers And Difficulty Breastfeeding’
I was misdiagnosed with mastitis twice because I had high fevers and trouble breastfeeding. It turned out to be cancer. Tumors were blocking the milk ducts. I was diagnosed with stage 3 breast cancer at age 32, five weeks after I had my first child. It didnt look like mastitis at all. So many people told me ‘100% chance’ it is nothing. No one thought of any alternative, however, until multiple courses of treatment failed.
Melissa Thompson, healthcare policy advocate, Stamford, Connecticut
Breast And Ovarian Cancer And Family History Risk Categories
This table provides examples of average, moderate, and strong family health histories of breast and ovarian cancer. This may help you understand if you have an increased risk for these cancers based on your family health history.
Note: This table does not include all possible family health histories of breast and ovarian cancer. If you have concerns about your family health history of breast or ovarian cancer, please talk to your doctor. Your doctor may assess your risk based on your personal and family health history, using one of the following:
Results may vary, depending on the tool used, and may differ from the risk categories below, which are based largely on the guidelines from the National Comprehensive Cancer Network.1
First-degree = parents, brothers, sisters, children
Second-degree = aunts, uncles, nieces, nephews, grandparents, grandchildren
Triple negative cancers are a type of breast cancer that lack estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2.
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Screening Guidelines For Women At Above
MSKs breast cancer experts have developed separate guidelines for women who have a higher-than-average breast cancer risk for the following reasons:
- family history of breast cancer in a first-degree relative
- history of atypical hyperplasia
- history of lobular carcinoma in situ
- history of mantle radiation before the age of 32
- genetic predisposition for breast cancer
If you have an above-average risk of breast cancer for the reasons listed above, MSK doctors recommend the guidelines below.
* You Are At Average Risk If You Have:
- no symptoms of breast cancer
- no history of invasive breast cancer
- no history of ductal or lobular carcinoma in situ
- no history of atypia
- no family history of breast cancer in a first-degree relative
- no suggestion or evidence of a hereditary syndrome such as a BRCA mutation
- no history of mantle radiation
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What Is The Average American Womans Risk Of Being Diagnosed With Breast Cancer At Different Ages
Many women are more interested in the risk of being diagnosed with breast cancer at specific ages or over specific time periods than in the risk of being diagnosed at some point during their lifetime. Estimates by decade of life are also less affected by changes in incidence and mortality rates than longer-term estimates. The SEER report estimates the risk of developing breast cancer in 10-year age intervals . According to the current report, the risk that a woman will be diagnosed with breast cancer during the next 10 years, starting at the following ages, is as follows:;
- Age 30 . . . . . . ;0.49%
- Age 40 . . . . . . ;1.55%
- Age 50 . . . . . . ;2.40%
- Age 60 . . . . . . ;3.54%
- Age 70 . . . . . . ;4.09%
These risks are averages for the whole population. An individual womans breast cancer risk may be higher or lower depending on known factors, as well as on factors that are not yet fully understood. To calculate an individual womans estimated breast cancer risk, health professionals can use the Breast Cancer Risk Assessment Tool, which takes into account several known breast cancer risk factors.;
American Cancer Society Screening Recommendations For Women At High Risk
Women who are at high risk for breast cancer based on certain factors should get a breast MRI and a mammogram every year, typically starting at age 30. This includes women who:
- Have a lifetime risk of breast cancer of about 20% to 25% or greater, according to risk assessment tools that are based mainly on family history
- Have a known BRCA1 or BRCA2 gene mutation;
- Have a first-degree relative with a;BRCA1 or BRCA2;gene mutation, and have not had genetic testing themselves
- Had radiation therapy to the chest when they were between the ages of 10 and 30 years
- Have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have first-degree relatives with one of these syndromes
The American Cancer Society recommends against MRI screening for women whose lifetime risk of breast cancer is less than 15%.
Theres not enough evidence to make a recommendation for or against yearly MRI screening for women who have a higher lifetime risk based on certain factors, such as:
- Having a personal history of breast cancer, ductal carcinoma in situ , lobular carcinoma in situ , atypical ductal hyperplasia , or atypical lobular hyperplasia
- Having extremely or heterogeneously dense breasts as seen on a mammogram
If MRI is used, it should be in addition to, not instead of, a screening mammogram. This is because although an MRI is more likely to detect cancer than a mammogram, it may still miss some cancers that a mammogram would detect.
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Inherited Breast Cancer And Risk Reduction
Family history is a known risk factor for breast cancer, with elevated risk due to both increasing number and decreasing age of first-degree relatives affected. For example, in a large, population-based study, risk of breast cancer was increased 2.9-fold among women whose relative was diagnosed prior to age 30, but the increase was only 1.5-fold if the affected relative was diagnosed after age 60 years. While twin studies indicate familial aggregation among women diagnosed with breast cancer, identification of true germline mutations, including BRCA1, BRCA2, p53 , PTEN , and STK11 , are quite rare, on the order of 5%-6%.- However, the management of young women at an increased risk of developing breast cancer via a germline mutation requires careful consideration, as screening, risk reduction, and implications for relatives are of upmost importance.
Types Of Breast Cancer
There are several different types of breast cancer, which develop in different parts of the breast.
Breast cancer is often divided into either:
- non-invasive breast cancer ;;found in the ducts of the breast which has not spread into the breast tissue surrounding the ducts. Non-invasive breast cancer is usually found during a mammogram and rarely shows as a breast lump.
- invasive breast cancer where the cancer cells have spread through the lining of the ducts into the surrounding breast tissue. This is the most common type of breast cancer.
Other, less common types of breast cancer include:
- invasive lobular breast cancer
- inflammatory breast cancer
It’s possible for breast cancer to spread to other parts of the body, usually through the blood or the axillary lymph nodes. These;are small lymphatic glands that filter bacteria and cells from the mammary gland.
If this happens, it’s known as secondary, or metastatic, breast cancer.
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‘my Dog Found My Cancer’
I had just been to the ob-gyn for my annual check-up and breast exam, and got the ‘all okay.’ Soon after, my little dog Zoe climbed up on me and started pawing at a specific part of my breast. Little alarms went off in my head, telling me to pay attention. It was like a slow-motion movie. I pushed her off and thats when I found a little round BB-sized lump. After a mammogram that didnt show anything, and a sonogram that found the lump, I was diagnosed with stage 2 breast cancer. Its so important to listen to the messages our bodies are telling us.
Christine Egan, author of The Healthy Girls Guide to Breast Cancer, Bayport, New York
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What Is The Earliest Age For Breast Cancer
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How Does Breast Cancer Start
Breast cancer occurs when cells in the breast grow out of control. Different kinds of breast cells develop into different . Most breast cancers begin in the breast ducts or lobules . These are known respectively as invasive ductal carcinoma and invasive lobular carcinoma. Other less common types of breast cancer include inflammatory breast cancer and;ductal carcinoma in situ.
Though breast cancer is most common in women, men can develop it as well. A mans lifetime risk of breast cancer is about 1 in 883. This year, the American Cancer Society estimates that about 2,620 men will be diagnosed with breast cancer.
Should You Talk To Your Doctor About Breast Cancer
Understanding breast cancer risk factors, knowing your personal risk of developing breast cancer, and recognizing the signs and symptoms of breast cancer can help women seek the care that they need, when they need it.
Take our Breast Cancer Risk Quiz to learn more about your personal risk. The quiz takes less than one minute to complete.
If you are 40 years or older, schedule a mammogram. The Breast Center along with The American Medical Association, The American College of Radiology, the American Cancer Society, the Society of Breast Imaging, and the National Cancer Institute recommend that women start getting a screening mammogram every year starting at age 40.
You dont have to wait until youre 40 to talk to your doctor about breast cancer, though. Meet with the specialists at the Breast Center if you have questions or concerns about breast cancer or breast health. Request an appointment online or call 479-442-6266.
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Can I Screen With Ultrasound Instead
An ultrasound scan is also not a reliable stand-alone method of breast screening in young women. Its a useful targeted diagnostic tool for adding extra information when investigating a known abnormality, but its not accurate enough for generally scanning the breast and screening for cancer.
Lifestyle factors
You can reduce your lifetime risk of breast cancer by adopting healthy lifestyle choices while you are still young.
- Be active. Regular exercise is associated with a decrease in the lifetime risk of breast cancer. Read the World Health Organisations exercise recommendations.
- Maintain a healthy body weight. Women who are overweight or obese have a higher risk of breast cancer after menopause so its important to adopt healthy eating patterns early in life. Eat plenty of fruit and vegetables and stay away from junk food or make it only an occasional treat.
- Limit alcohol. Alcoholic drinks raise the levels of oestrogen in the body and contribute to breast cancer risk.
Guidelines For Genetic Testing For Breast Cancer
About 10% of breast cancers are related to inheritance of damaged genes. BRCA1 and BRCA2 are the genes most frequently implicated, but there are many other genes, such as PALB2, ATM, and CHEK2, that need to be considered as well.; Genetic testing usually starts with a family member who has already developed a breast or ovarian cancer.; If this individual is positive for a mutation then all of the other family members can be tested for the same mutation to determine who is high risk and who is not.; If no one in the family is known to carry a mutation then the test is considered non-informative.; That means the test was unable to tell us which relatives in the family are high risk. ;People who have inherited a damaged gene are at increased risk for breast and other cancers.; The risk may be as high as 80% depending on the specific gene and family history.;Guidelines for determining whether an individual should get genetic testing or not are constantly evolving. General criteria include:
- Someone in your family is known to carry a mutated gene
- Ashkenazi Jewish ancestry
- You were diagnosed with breast cancer before age 50
- A man in your family has been diagnosed with breast cancer
- You were diagnosed with ovarian cancer
- There are multiple breast cancers on one side of your family
- Cancer was diagnosed in both breasts
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