Local treatment of older women with early stage breast cancer

I looked really hard but could not find the difference in overall survival between women over 80 who received surgery and those who didn't. So if that's the title, I wish they would say how much longer they lived!

Hi Besa, I did see that, but there didn't seem to be anything about overall survival, which is what the title implies. Just seemed like a bit of bait and switch. The actual scientific article has it right, though.

I'm actually surprised at the BCSS times. I would not expect them to be so long for women already in their 80's. Which is the point of the study, it appears. If women in their 80's with early stage BC get surgery, they can survive BC much longer. Still wondering if they end up living longer, or not, compared to their peers.

I went back and read the study more closely and it is thought provoking. http://www.journal-surgery.net/article/S1743-9191(13)00146-5/fulltext#sec4

Although the women in this study were twice as likely to die of other things than of breast cancer (69% vs. 31%), those with early stage BC who dodged other bullets could live an average of 9 years before being killed by breast cancer if they got surgical treatment along with endocrine therapy. That was 58 months longer than the early stage women who didn't get surgery. Since the average life expectancy of a Spanish woman is 85 years, I was surprised that these women lived that much longer. But actuarial tables for U.S, women (whose average life expectancy is 81) show an 84 year old woman could expect to live another 7.37 years. https://www.ssa.gov/oact/STATS/table4c6.html. I wonder if a lot of doctors make the same assumption I did, that once you reach your 80's you are unlikely to live longer. I also wonder if that belief leads to undertreatment and higher breast cancer mortality among women over 84. SEER statistics show that age group comprises 5.7% of diagnosed cases, but 16.6% of the deaths. http://seer.cancer.gov/statfacts/html/breast.html

There are several weaknesses to the study that I see. One, the age difference between the women who got surgery and those who didn't wasn't statistically significant, but it did exist. Those who got surgery were on average 1.4 years younger. There were also differences between the two groups in chemotherapy (17.15 vs. 11.9%), radiation (24%vs 19%) and endocrine therapy (80% vs. 75%) use that weren't significantly different, but stacked up in favor of the women who got surgery. The other major weakness was the lack of information on comorbidities. It could have been that the women who did not get surgery had other health issues that made them worse candidates for surgery and those comorbidities contributed to a faster progression of their breast cancer.

Anyway, since lumpectomies are usually pretty easy to recover from, this study does make me think more elderly women should be getting them.