Post-op cancer therapy less likely for older women
Post-op cancer therapy less likely for older women
Invasive breast cancer is the second leading cause of cancer death in older women. Yet, a recent study by researchers at the Massey Cancer Center at Virginia Commonwealth University in Richmond found that the older women become, the less likely they are to receive chemotherapy or radiation treatment after breast surgery to prevent cancer recurrence.
In addition, the study found that older women are less likely to have axillary lymph nodes assessed to determine how far their cancer has spread.
Researchers examined the patterns of initial breast surgery (i.e. forms of mastectomy and breast conserving surgery, or BCS), cancer stage, and adjuvant therapy for 3,361 women with local and regional breast cancer listed in the Virginia cancer registry from 1985 to 1989. They linked the data to Medicare claims and census data for the same years.
Study findings include the following:
• Use of chemotherapy declined by more than 60% per decade of age.
• Radiation therapy declined from more than 60% for women age 65 to 69 to only 7% of women age 85 and older.
• The probability that a woman would not receive an axillary lymph node assessment increased 2.5 times for every decade of age.
Researchers noted that comorbidities common in the elderly may prevent physicians from treating breast cancer more aggressively in older women.
(See: Hillner BE, Penberthy L, Desch CE, et al. Variations in staging and treatment of local and regional breast cancer in the elderly. Breast Cancer Research and Treatment 1996; 40:75-86.)
• The Second Annual Disease Management Congress Sept. 2-5, Washington, DC. Sponsored by the National Managed Health Care Congress (NMHCC). Contact: NMHCC Inc., P.O. Box 360034, Boston, MA 02241-0634. Telephone: (617) 505-8000. Fax: (617) 663-6411.
• Transforming Care Delivery: Bridging Concepts and Practices Sept. 21-23, Minneapolis. Sponsored by the National Chronic Care Consortium (NCCC). Contact: NCCC, 8100 26th Avenue South, Suite 120, Bloomington, MN 55425. Telephone: (612) 858-8999. Fax: (612) 858-8982.
• MGMA 1997 Annual Conference: The Group Practice Summit Oct. 5-8, Washington, DC. Sponsored by Medical Group Management Association (MGMA). Contact: MGMA, 104 Inverness Terrace East, Englewood, CO 80112-5306. Telephone: (303) 397-7888. Fax: (303) 643-4439.
• NMH/IT Fall: Integrating and Shaping the World of Managed Care Nov. 3-6, Los Angeles. Sponsored by NMHCC. Contact: (See first listing.)
• The Second Annual Disease Management Congress: Outcomes Measurement & Quality Improvement Feb. 9-12, Pasadena, CA. Sponsored by NMHCC. Contact: (See first listing.)
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