Way back in 2004, evidence surfaced that breast radiation after a lumpectomy wasn’t doing older women a whole lot of good. A decade later, nearly three-quarters of women over age 70 continue to receive radiation for early-stage breast cancer. Is this treatment really necessary?
Breast cancer is an older woman’s disease.
Despite the heavy media coverage of breast cancer battles fought by celebrities like Angelina Jolie, Christina Applegate, and Robin Roberts, the majority of women diagnosed with breast cancer are over age 60. Which isn’t surprising; the main risk factor for breast cancer, after being female, is growing older.
Thus it’s imperative that research news potentially affecting an enormous number of breast cancer survivors goes mainstream.
Sure, if there was a silver-bullet cure for cancer, we’d hear about it. A breast cancer vaccine? The media would be all over it. But how about data that could dramatically cut the cost of treatment, its risk, and its side effects, both temporary and permanent" wouldn’t you assume doctors would hear about the study, and use it to guide treatment decisions?
Apparently not. At least judging by the medical community’s response to a 2004 study showing that for women over 70 with early-stage breast cancer, radiation doesn’t increase either survival rate, nor decrease risk of cancer recurrence.
Prior to the study, 68.7% of women over 70 with early-stage breast cancer received radiation. In the 5 years after the study’s release, that number dipped to just 61.7% - a reduction of just over 10%. Why are so many older patients still receiving radiation?
Well, several reasons. First, the study does have a potential flaw. It involves only Medicare patients, not the general population. Though, to be fair, one would assume most of the general population over age 70 receives Medicare benefits.
In addition, and this is more important, the study only tracked survivors for 5 years after treatment. Will the post-5-year survivor group that didn’t receive radiation show a sudden uptick in recurrence and death risk at 10 years? At 15? Only time will tell.
Finally, the study authors offer that doctors may be reluctant to discontinue a treatment that for decades has been assumed effective - despite new information that points to its ineffectiveness.
And that caution may be warranted. Who knows if those study results may change over the next 10 to 15 years?
Still, considering radiation’s potential side effects, the slog to the hospital every day for weeks, and its cost, it’s tempting to be able to say, "No thanks, Doc, I’ll pass."
If you’re over 70, and have been diagnosed with early-stage, hormone-receptor positive breast cancer, ask your oncologist, "Do I really need radiation?" It’s worth a discussion, at least.
McIntosh, James. “Most Elderly Breast Cancer Patients Receive Unnecessary Radiation.” Medical News Today. MediLexicon International. Web. 8 Dec. 2014. https://www.medicalnewstoday.com/articles/286539.php.
PJ Hamel is senior digital content editor and food writer at King Arthur Flour, and a James Beard award-winning author. A 16-year breast cancer survivor, her passion is helping women through this devastating disease. She manages a large and active online survivor support network based at her local hospital and shares her wisdom and experience with the greater community via HealthCentral.com.