Breast Cancer in Older Women: What You Need to Know

Medically Reviewed By: Rachel A. Freedman, MD, MPH

American women have a 12 percent lifetime risk of being diagnosed with breast cancer, the second most common cancer in women, according to the American Cancer Society. While young women do get breast cancer, the disease is much more common in women aged 60 and older.

Rachel Freedman, MD, MPH, treats patients with breast cancer, focusing on the care of older patients, including breast cancer in older women.
Rachel Freedman, MD, MPH, treats patients with breast cancer, focusing on the care of older patients, including breast cancer in older women.

Rachel Freedman, MD, MPH, a medical oncologist at the Susan F. Smith Center for Women’s Cancers at Dana-Farber, explains what older women should know about breast cancer:

Menopause can impact breast cancer risk.

The risk of breast cancer increases with age, and the age at which a woman enters menopause can also impact her risk. A woman who enters menopause later than age 55 has a slightly higher risk of developing breast cancer than a woman who went through menopause earlier, likely due to increased exposure to estrogen.

Mammograms may not always be recommended.

Women who are not at an elevated risk of breast cancer (i.e. do not have a family history or certain genetic mutations) should receive mammograms annually or every two years after age 50. However, the age to stop mammograms is less clear. Older women with other serious medical issues should discuss the benefits of mammography with their physician, as it may make sense to stop mammography at some point and monitor risk through physical exams. Patients should develop a personalized plan for screening and surveillance with their doctors based on their current health and medical history.

Treatment options may change with age.

While younger patients often require a combination of chemotherapy, surgery, and radiation to treat breast cancer, older women are less likely to require chemotherapy and radiation to treat their disease because of the more favorable types of cancers they tend to develop.

For example, studies have shown that women aged 70 or older with small, estrogen-sensitive tumors may not require radiation following a lumpectomy and can do well without this treatment. Women with these types of tumors often do not require chemotherapy either.

In some cases, older women may be recommended for chemotherapy, which can cause more significant physical side effects than in younger women. The impact of potential side effects on a woman’s daily life should be taken into account when weighing the risks and benefits of any treatment plan.

Many older women with breast cancer don’t die from it.

There are more deaths from breast cancer in older women simply because most diagnoses occur in older women, but most of these women will die from a cause other than their breast cancer. Breast cancer survival rates, for women of any age, depend on the cancer’s stage and subtype.

Any woman, regardless of age, who has a family history of cancer, particularly breast and ovarian, should bring it to the attention of her physician, who can evaluate potential breast cancer risk, the need for genetic testing, and the proper screening plan to follow.

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About the Medical Reviewer

Rachel A. Freedman, MD, MPH

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