The prognosis for hormone-dependent breast cancer worsens with age. The results of this study should lead to more personalization of the treatments.
Until now, it was thought that when breast cancer was discovered after menopause, the chances of recovery were greater than for a young woman. False hope. According to an international study which observed more than 10,000 patients, mortality linked to hormone-dependent breast cancer (or RH +) increases with age and increases particularly after 75 years.
Dr Daniel Serin, oncologist, Institut Sainte Catherine, Avignon: “Be careful, age would be a factor of poor prognosis”
A single study cannot be enough to call into question all the knowledge acquired, but this study published in the prestigious journal of the American Association of Medicine is really surprising. How to explain this increase in mortality with age? The study was not designed to answer this question, but the authors put forward several hypotheses. Elderly patients may respond less well to treatment.
Dr Daniel Serin: “Maybe the treatments would become less effective after 74”
Clinical trials, these studies which make it possible to test the effectiveness of a drug, are indeed rarely carried out in patients over 75 years of age. However, at this age, we often take several drugs a day to treat hypertension, diabetes, osteoporosis … We therefore do not know how these other drugs affect the effectiveness of cancer treatment.
Second hypothesis, cancers of older women are under-treated. We are more reluctant to impose radiotherapy or high-dose chemotherapy on an 80-year-old woman. What is at first glance a precaution in the face of more fragile patients is in fact detrimental for the development of their cancer.
Dr Daniel Serin: “Age should not be a criterion for reducing therapeutic ambition”
These new results further reinforce the need to adopt the same aggressive attitude with the tumor regardless of the woman’s age. A limitation all the same, what the doctors call the commorbidities, in other words, the other diseases of the patient. They can be a risk factor that prevents the use of certain treatments. There is more and more talk of individualized cancer care, in particular depending on the nature of the tumor. If these results are confirmed, old age could become an additional factor in the personalization of treatments.