Older Age Worsens Breast Cancer Prognosis

dogsandjogs

When I saw my breast surgeon he explained about taking out the sentinel node. And then he said "But if it has cancer in it, I'm not going to take out more nodes, are you ok with that?" I was kind of surprised. Why wouldn't he take out more? Because of my age (75)?

I have heard that cancers grow more slowly when you are elderly so maybe that was the reason.

RMlulu

Dogsandjogs - No, the sential node dissection is used to determine if cancer has reached your nodes... My BS looked at 7 nodes checking for cancer they were all clear...if the 1st had cancer he would have stopped there...not age dependent at all.



This site has great information on the procedure and how it is a tool used by your surgeon to determine your status and treatment.



Cancer is an equal opportunity non age discriminating sneaky evil disease.

Good luck in your treatment!

dogsandjogs

I wonder why they took 7 in your case and only 1 in mine? Not that I'm complaining ---in 1982 they took out 17 at the time of the mastectomy/reconstruction. Luckily I had minimal swelling afterwards and was back to running in three weeks 

Hindsfeet

I was dx after turning 60. I was told that it was normal for someone my age to be dx with cancer, not a big deal in that the younger women had more aggressive cancers. Not so...I was dx now 4 times in my 60's with grade 3, como, her2 +++. Being older, I choose to do minimal treatment. I did do Herceptin for 4 or 5 months, but do to my EF dropping so low, I had to quit. I will admit, I thought being older, it would be years before I had another dx...had no idea they would piggy back or a recurrences so quickly. It's been two years since my 4th dx...hopefully cancer is behind me, but as I age, perhaps not.

While taking Herceptin infusions, in the chemo lounge, I saw a woman who was given chemo, who must have been 85 to 95.. She looked half dead. I felt so sorry for her. I saw no reason for her to be treated so aggressively. There is no way she was going to make it. She was literally a skeleton. She was brought in on a stretcher. I saw other older people coming in with walkers, who looked too frail for chemo. It seems too harsh of a treatment for the elderly. Although I'm in my 60's, I feel as if it would do me in. I would not consider myself elderly as I work full time, and I'm very active. Someone in their 60's is different than someone 75 and older. It all depends.

Alfieval

I am 71 and have just had mastectomy with sentinel node biopsy waiting for results of biopsy and if needed I will Agee to what is advised. Nobody has mentioned my age at any stage of treatment so far ha ha  all the best everyone out there. Alfieval

Kicks

I haven't posted in this thread in a bit over 2 yrs but thought I would - I still feel the same as I did then.  I refuse to not do everything I can to fight to make each the best/most enjosyable Ican.  Life is to be lived and foight for (if necessary) in any way possible.

I was 63 'back then' when DXd and am now 68.  This month is 5 yrs since DXd Stage IIIc IBC - I'm still here, NED and living/loving every day I am blessed to have.  Has every thing been perfect -of course not!  My arthritis is worse in upper back but not bad enough to slow me down.  I slipped on a dog bone in our hall and 'did a good job' on wrist but surgery took care of it.  A year ago last July, the retina detached in right eye (first Dr I had at a large eye center was less than competent but did get to a fantastic Dr in time).  This June left eye detached retina but I was able to get into the great Dr immediately.  I had been to town and coming home I realized that it was detaching so as soom as I walked im the door I called his office, talk to one of his RNs, she talked to him and I was told to get into the office as fast as I safely could.  I did, was treated immediately and doing great.

Back to age - I have never been told that my age had anything to do with my IBC TX plan or my prognosis.  Or with how any of other issues are handled.  Of course we are each unique in so many ways before we have 'something' to deal with.  Our Drs are also unique in how they treat us and our 'issues'.  In my case, even though I was 63 at DX, I was VERY healthy and very active.  I had/have horses, bicycle, garden, mow (my yard and for several others who need a little help) with my push mower.  In the yrs since DX, I have taken up fly tying/fly fishing/rod building (through Project Healing Waters), flint knapping and Woodfellow carving.  So yeah, I stay busy but it keeps me active.  I definately realized that the things I'm intersted in aren't what many/most women would want to (or could) do - it's what helps to keep me/who I am young in 'spirit' even when body reminds me it isn't what it was at 20/30/40/50/60.

As I've not run into anything being said about any TX being based on my age, I can't know exactly what I would do IF I ran into such an attitude but I think I would be finding a new Dr  ASAP, one who would give me the best care possible.  I can see how some pre-existing health issues can effect what TXs can be done but that is different than being healthy but with a few more years under the belt.

I believe 'Old' is 'relative' to the person involved.    Mom's mother was OLD for as long as I can remember(she lived with us from the time I was 4) in her outlook/attitude.  On the other hand, Daddy's mom was never 'OLD' though she lived to 96.  She was healthy, lived alone, ran a small seasonal business, had rental property, was very active in Church, Eastern Star and politics.    I intend to follow her, and both of Daddy's Grandmothers who were also very active into their mid/late 90's too.

Sorry for rambling on so much.

Oh one last thing - my Faith is a very strong 'staff' that helps me along my Earthly journey to return home to my Heavenly Father.

booksfallopen

Age [67] was never mentioned when I was diagnosed approximately Feb-Mar 2014, learned my daughter was pregnant, planned a wedding in one week [timing was planned for this year, but what happens happens] began chemo April 2014, had surgery Sep 17 with expander placement right after surgeon finished mastectomy. Oct 4 helped 2 friends who were throwing a baby shower for my 39 year old daughter - first grandchild was born the following day Oct 5! If that granddaughter wasn't reason enough to ask questions & do everything possible to beat this, I don't know what else would. After the best results anyone could have in the last year I will continue to do everything needed to stay on this recovery path.

Age be damned - it is just a number. That baby, 9 months now, changes every day and I want to be here as long as possible to keep seeing her grow.

lscrivy

Oh, Ladies... what a hot topic of discussion. Glad I found you.

My mom is 78 and was just diagnosed with Invasive Mammary Carc., mixed ductal and lobular (but primarily lobular?). She has a 7cm nodule and possible one 5mm lymph node. Grade 2. No surgery yet. My guess is probably stage IIb, but we may find differently after surgery. I just read in this thread above that medicare wont cover prophylactic removal of the second breast... hate to hear that as my mom was leaning in that direction (and of course she is on medicare). However, she is also afraid of compromising her quality of life. At 78, she has COPD but is fairly active. I was wondering if we might should seek a geriatric oncology specialist but reading this post makes me wonder if they would recommend less-than-optimal treatment based on her age.

We dont yet know her receptor status, lab has not completed the results yet (just found out on Dec 23-- Merry Christmas to us

She has appt at MDACC on Jan 11, and with a local surgeon this coming Monday. She is leery of being that far away from home (we live in Alabama) but I prefer a Comprehensive Cancer Center ... our local hospitals got an 18/100 and 22/100 on US News and World Reports for hospitals ~!

Any surgeon recommendations, MO recommendations, centers, etc would be most appreciated, along with any other advise. Much to learn in a short amount of time and I know that these support groups are a gold mine of information. Thanks in advance !

windingshores

There is a federal law on the books that guarantees symmetry for women dealing with mastectomy. I would ask the surgeon about this.

The changes in philosophy of care is hard to grasp at first, but generally speaking it is no longer considered the best course of action to "throw everything" at the cancer. Some tumors don't respond to chemo, for instance, and there are now tests to determine that, at least in part. And weighing the risk of shorter life span from side effects is important too: chemo, again as an example, might lower the risk of recurrence or spread without improving life span or even shortening it.

And yes, that would be all the more likely with an older person with certain pre-existing conditions.

The Oncotype Dx test, Mammaprint and other recently developed tests are very helpful with all of this.

ChiSandy

My dx (after decades of regular and eventually annual screening mammos) came at 64. My MO told me that if my OncotypeDX came back intermediate or higher, my age would not be a factor in deciding about chemo--but that comorbidities (asthma and three major antibiotic allergies) and how side effects such as hearing loss & neuropathy would impact my present career as a performing musician, would be. Fortunately, my score was 16, still in the “low” range with chemo adding less than a 2% advantage (survival as well as likelihood of being mets-free in 10 yrs) over just rads & AIs w/o chemo. But I will admit that if I’d been 44 or even 54 I might have thought twice and opted for it if recommended. But my age, tumor profile and location were cited by my RO as reasons to do partial-breast double-dose short-protocol rads-- the study in which he just finished participating showed no difference in disease-free survival between the std. and the short-partial-intense protocols in women over 60 with my kind of IDC. So I chose the short protocol. No regrets. If it recurs or I get a new primary locally, more rads would probably not have made a difference.

Positive2strong

• dlb823 hello, did you have chemo ? My doc said now I should have chemo to lower reacurrance rate by 10% I am stage 1 grade 2/3 her2-
• I thought radiation and hormone therapy would be it.
• I am 66 your thoughts
• Positive

sharethehope

I have noticed a disadvantage for older ladies where I live now but never before so maybe is due to local attitudes on age. Don't know just really hate to be dismissed.

ChiSandy

Hi, Positive. I don’t think your age has anything to do with your onc’s recommendation for chemo. Rather, the fact that you’re PR- makes your tumor more aggressive (recent research, albeit done just on mice so far, indicates that progesterone does help ER+ tumors resist estrogen when given endocrine therapy, and thus makes them more “indolent;” but without PR receptors, the tumor cells can’t access progesterone). Chemo works better on cells that divide more rapidly—Luminal B tumor cells divide more rapidly than do Luminal A—and therefore the benefits of chemo outweigh the burdens. Chemo would have lowered my recurrence risk by only 2%, and it was in the single digits to begin with.

What was your OncotypeDX score? That also might have factored into your onc’s recommendation.

You might want to ask about cold-capping during chemo to save a lot of that gorgeous hair .

Meow13

PR- is more aggressive?, I think it is more rare therefore not understood as well. Mine was less than 1% pr and er 95%. My oncodx was high risk but that was using tamoxifen not AI drugs. More data is surfacing but there are not as many people with er+ and pr- cancer I think even less with er- pr+. My mitotic rate was scored 1 in both tumors not dividing rapidly two very different things.