Odds Good for Older Women With DCIS, Early Breast Cancer

By Charles Bankhead, Staff Writer, MedPage Today

A diagnosis of ductal carcinoma in-situ (DCIS) or stage I breast cancer does not reduce survival odds for women older than 67, but diagnosis of a higher-stage malignancy does, an NIH database analysis showed.

Women with DCIS or stage I breast cancer had mortality hazards of 0.9 to 1.0 compared with age-matched women who did not have breast cancer, according to Mara A. Schonberg, MD, of Beth Israel Deaconess Medical Center in Boston, and colleagues.

However, the mortality risk increased by 50% compared with controls with a diagnosis of stage II or higher breast cancer, they reported online in the Journal of Clinical Oncology.

"More women age 67 years and older diagnosed with DCIS or stage I breast cancer and women age ≥80 years diagnosed with stage II disease die of cardiovascular disease than breast cancer," Schonberg and colleagues wrote in the discussion of their findings.
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Late Breast Cancer Diagnosis In Elderly Leads To Poor Survival

Women over 70 are being diagnosed with breast cancer at a later stage leading to lower survival from the disease in the elderly, new research showed today (Wednesday).

The study, published in the British Journal of Cancer*, also found that older breast cancer patients were less likely to receive the same level of treatment as younger patients.

Scientists said that improving access to treatment, in particular surgery, among the elderly could significantly improve their breast cancer survival.

They found that it was also important for women to report any symptoms to their GP as soon as they noticed them and be aware they could continue to have access to screening.

The research analysed over 14,000 women diagnosed with breast cancer between 1999 and 2007 from Eastern Cancer Registration and Information Centre (ECRiC) and looked at five and ten-year survival for patients in four different age groups.**

The results showed that women diagnosed with breast cancer between 50 and 69 years had an 89 per cent chance of surviving their disease for five-years.***

However this fell to 81 per cent for women aged 70-74 years old and to 70 per cent for women over 80.

Three per cent of women in the 50-69 age group were diagnosed with breast cancer at a late stage.**** These women would have been routinely invited for a mammogram every three years through the national screening programme.

In comparison, eight per cent of women 70-74 and 10 per cent of women over 80 had a late stage diagnosis.

Women diagnosed at a late stage had a 14 per cent chance of surviving their disease for five-years.

Dr Paul Pharoah, a Cancer Research UK-funded scientist and one of the study's authors based at the University of Cambridge, said: "This study suggests that improving the way breast cancer is diagnosed and treated in the elderly could mean fewer die prematurely from the disease.

"The national breast screening programme is very good at picking up cases of breast cancer in 50-70 age group it is aimed at.

"But more needs to be done to raise awareness of the disease in older women who are not automatically invited for mammograms, especially since risk of the disease increases with age."

The research also suggested that older women did not always receive the same level of treatment for breast cancer as younger patients.

Around 96 per cent of women aged 50-69 years old had surgery for breast cancer, but this fell to around 60 per cent for women over 70.

Dr Pharoah said that factors like patient preferences, suitability and other illness could explain the differences in treatment - but only to a certain point.

He added that more detailed diagnoses of breast cancer in the elderly could ensure that older women suitable for treatments like surgery, chemotherapy and radiotherapy received them.

Sara Hiom, director of health information at Cancer Research UK, said: "We know that older people are less likely to survive breast cancer - this study highlights that many factors are at play and that late diagnosis and varying access to treatment, in particular, are playing a key role.

"Late diagnosis in the elderly could also be down to women delaying a visit to the doctor, so it's really vital that women are aware of breast cancer symptoms.

"After they turn 70, many women assume that breast cancer is less of a risk because they are no longer invited for screening but this isn't the case.

"More must be done to ensure that older women are well informed about their breast cancer risk, their option to ask for a mammogram and are consistently offered a full range of treatment options where this might benefit them.

"Further work needs to be done to understand why there are these large differences in breast cancer survival between older and younger women so that we can work to ensure that this gap is closed."

Reference

*Ali, A MG et al., Patient and tumour characteristics, management, and age-specific survival in women with breast cancer in the East of England, British Journal of Cancer (2011)

Notes

**Four age groups were: 50-69 years-old, 70-74 years-old, 75-79 years-old and 80+

***after adjusting for the probability of dying from another illness

****Late stage is classed as stage four breast cancer. This means the cancer has spread to other organs in the body and curative treatment may no longer be possible.

Source:
Cancer Research UK

TIME GOES BY | When Does Old Age Begin?

by Ronni Bennett

Last week, on a post titled, A Day in an Elder's Life, reader Flora Davis posted this comment:

“You know, I was shocked to hear that you're 69. I'm 76, and to me 69 seems like a kid. I'm still waiting to feel 'old,' whatever that means.

“Seriously, when would you say old age begins? Are we simply as old as we feel? And what would that mean since it changes from day to day?”

That oft-repeated adage we've heard all our lives - you're only as old as you feel – is nonsensical. Since no one has before been the age they are, that's how that age feels. How could it be otherwise?

Further, is it possible for anyone to feel the same at 75 as they did at 60, 50, 40 or 30? I hope not. That would imply no change, no learning, no new knowledge over all those years. Events, experience, joys, tragedies, successes and failures (taking into account individual degrees of self-awareness) should and do change us, teach us and, sometimes, make us a little wiser. It happens only with the passage of time.

Now and then throughout most people's lives, someone, on being told our age, is bound to say, “Oh, you don't look that old,” and it is invariably taken as a compliment because to look old is the ultimate sin in American culture.

The pressure to look young surrounds us every day of our lives in newspaper and magazine advertisements, television commercials and such shows as Nip/Tuck, comedians' jokes and job-seeking advice. Oprah Winfrey has made the pursuit of youthful appearance a fetish for 20 years.

A lot of the cultural abhorrence of old age is the word “old” itself. Here is a list of synonyms for “old” from one online thesaurus:
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Style Without End - NYTimes.com

Image via CrunchBase
By PAULA SPAN

Ari Seth Cohen can probably blame his fascination with glam older women on his grandmothers.

His mother’s mother, whom he describes as “my best friend, growing up,” successfully lobbied for him to leave Seattle, where he’d been working in galleries and in a men’s store, and to move east. “She always told me New York was where everything is happening, and if I wanted to do something creative, I should be there,” he told me.

His father’s mother was a fashion plate who took him shopping at Escada. “She wore beautiful suits and jewelry, a very elegant woman,” Mr. Cohen recalled.

When he did move to New York, initially taking a job in a museum bookstore, he noticed a number of idiosyncratically chic older women on the streets. He took to carrying his Canon Rebel digital camera with him everywhere, snapping their photos. The result is the blog Advanced Style, launched in 2008, which declares itself “proof from the wise and silver-haired set that personal style advances with age.”

“Older people are comfortable in their own skin, and they wear their style with confidence,” Mr. Cohen explained, sounding a bit envious. He’s a mere 29.

That appearance matters, at least to a number of old people, is something lots of nursing home, assisted living and adult day staffers can testify to. There’s a reason so many of these facilities have beauty salons on site, a reason many women cling to their red lipstick and hair color when even walking becomes difficult.


I often hear complaints about the limited range of clothing designed for older women who disdain pastel velour tracksuits. You won’t see a lot of those on Advanced Style.

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