Breast Cancer & Older Adults

Appointments Mature Black woman in pink sweater with doctor
  • Overview
  • Our Approach
  • Appointments
  • Diagnosis
  • Treatments
  • Impact
  • Prognosis & Follow-up Care
  • Resources
  • Locations
  • Physicians

    •  

    Breast cancer in older adults, typically defined as those aged 65-70 and older, presents unique challenges and considerations in diagnosis, treatment, and survivorship. This demographic often faces different medical, psychological, and social implications compared to younger women. Age is used to determine certain aspects of breast cancer treatment, such as the use of lymph node surgery in select patients.
     

    Incidence and Characteristics

    The risk of developing breast cancer increases with age. Most breast cancers are diagnosed in women aged 55 and older.

    Older adults are more likely to be diagnosed with hormone receptor-positive (ER+ and/or PR+) cancers, which tend to be less aggressive than other subtypes.  Learn more about tumor receptors and breast cancer.

    Risk Factors 

    • Age: The most significant risk factor. The likelihood of developing breast cancer increases as women age.
    • Genetics and Family History: A family history of breast cancer and genetic mutations (BRCA1, BRCA2, etc.) still play a significant role.
    • Reproductive History: Factors such as late menopause, having children late in life, or not having children can increase risk.
    • Lifestyle Factors: Obesity, lack of physical activity, excess alcohol consumption, and smoking can also contribute.

    Our Approach

     

    Breast cancer in older adults requires a multidisciplinary, personalized treatment approach that considers the patient’s overall health, comorbidities, functional status, and personal preferences. The primary goal is to balance effective cancer treatment with the quality of life.

    The Weiser Family Center for Breast Cancer at the U-M Health Rogel Cancer Center is dedicated to providing compassionate, cutting-edge care for young adults affected by breast cancer. We enhance lives through early detection, personalized treatment, and survivorship support, while advancing research, education, and advocacy. Our unwavering commitment is to make a meaningful difference, improving breast cancer outcomes for all.

    Appointment Information

     

    If you've been diagnosed with breast cancer and would like an appointment, please call 734-647-8902.  Healthcare providers looking to refer a patient, please contact M-LINE: 800-962-3555.

    Diagnosis

     

    • Screening: Mammograms remain an essential screening tool, but recommendations for frequency may vary based on individual health status and life expectancy. Some guidelines recommend continuing mammograms every 1-2 years for women aged 55 and older, as long as they are in good health.
    • Symptoms: Symptoms may include lumps, changes in breast size or shape, skin changes, nipple discharge, or new pain in one part of the breast.
    • Diagnostic Tests: Mammograms, ultrasounds, and biopsies are standard for confirming a diagnosis. MRI’s may be used in select situations.

     

    Challenges in Diagnosis

    • Comorbidities: Older adults often have other health conditions (e.g., heart disease, diabetes) that can complicate the diagnosis and treatment.
    • Delayed Detection: Symptoms might be overlooked or attributed to aging, leading to later-stage diagnoses.

    Treatment Options

     

    Individual treatment plans for older adults often need to be tailored, taking into account overall health, life expectancy, comorbidities, and functional status:

    1. Surgery:
      • Lumpectomy: Removal of the tumor and a small margin of surrounding tissue; typically followed by radiation therapy.
      • Mastectomy: Removal of the breast; may be considered based on the cancer's extent and patient's health status.
    2. Radiation Therapy: May be recommended after a lumpectomy. Daily trips for radiation can be taxing, so the patient’s ability to attend sessions should be considered. Radiation may also be recommended in select situations after mastectomy depending on the cancer stage.
    3. Chemotherapy: Less frequently used in older adults due to potential side effects and comorbidities. However, it might be necessary based on the cancer's aggressiveness and stage.
    4. Hormonal Therapy: Often recommended for hormone receptor-positive cancers. Medications like tamoxifen, aromatase inhibitors, or selective estrogen receptor modulators (SERMs) can be effective and generally have fewer severe side effects.
    5. Targeted Therapy: Drugs like trastuzumab for HER2-positive cancers can be part of the treatment regimen.
    6. Palliative Care: Focuses on quality of life and symptom management, especially important in older adults with advanced cancer or severe comorbidities.

     

    Considerations for Treatment

    • Comorbid Conditions: Must be carefully managed alongside cancer treatment to minimize complications and maximize quality of life.
    • Functional Status: Physical and cognitive functions can influence the choice and intensity of treatment.
    • Life Expectancy: Treatment goals may differ for older adults, focusing more on quality of life rather than aggressive interventions, especially if life expectancy is limited.

    Psychosocial and Emotional Impact

     

    • Support Needs: Older adults may need more support, especially if they live alone or have limited mobility.
    • Independence: Maintaining independence and daily function can be crucial for older patients.
    • Social Networks: Ensuring robust social support networks can help with emotional well-being and practical support.

    Learn more about the Rogel Cancer Center's Patient & Family Support Services.

    Prognosis & Follow-up Care

     

    • Generally Favorable: Many older adults have hormone receptor-positive cancers that respond well to treatment.
    • Depends on Overall Health: Co-morbid conditions and general health play significant roles in determining outcomes.

     

    Follow-Up Care

    • Regular Monitoring: Essential to detect recurrence and manage treatment side effects.
    • Comprehensive Care: Involves not only oncologists but also primary care physicians, geriatricians, and other specialists as needed.

    Locations
    • Breast Care Clinic | Brighton Center for Specialty Care 7500 Challis Rd
      Entrance 1, Level 1
      Brighton, MI 48116-9416       Get Directions
    • Breast Oncology Clinic | Rogel Cancer Center 1500 E Medical Center Dr
      Floor 1
      Ann Arbor, MI 48109-5916       Get Directions

    Doctors

     Search for a U-M Health doctor

    Steven Goble Allen, MD

    Clinical Assistant Professor

    Radiation Oncology

    Monika Leigh Burness, MD

    Monika Leigh Burness, MD

    Assistant Professor

    Medical Oncology, Internal Medicine

    Erin Frances Cobain, MD

    Erin Frances Cobain, MD

    Associate Professor

    Medical Oncology, Internal Medicine

    Michigan Photo

    Aleksandar Filip Dragovic, MD

    Clinical Associate Professor

    Radiation Oncology

    Norah Lynn Henry, MD

    Norah Lynn Henry, MD, PhD

    Professor

    Medical Oncology, Internal Medicine

    Borislav Hristov, MD

    Borislav Hristov, MD

    Clinical Assistant Professor

    Radiation Oncology

    Tasha Michelle Hughes, MD

    Tasha Michelle Hughes, MD

    Clinical Associate Professor

    Surgical Oncology, Surgery

    Elizabeth Maria Jaworski, MD

    Elizabeth Maria Jaworski, MD, MS

    Clinical Assistant Professor

    Radiation Oncology

    Jacqueline Sara Jeruss, MD

    Jacqueline Sara Jeruss, MD, PhD

    Professor

    Surgery

    Kathleen Anne Kemmer, MD

    Clinical Assistant Professor

    Medical Oncology, Hematology, Internal Medicine

    Show All Doctors