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Capstone

The Screening, Diagnosis, and Treatment of Breast Cancer in Women of Marion County: Are Elderly Women Being Under-Treated?

1 August 2005

Abstract

Context: Breast Cancer-is the most common cancer among women and the second leading cause of cancer death among women. Overall more focus is directed at younger women with breast cancer and as a result there is a lack of attention and research studies addressing elderly women with breast cancer. The increase in life expectancy continues to rise in our society as well as the predicted increase in the overall geriatric population. With the increase in the geriatric population more attention needs to be directed at the screening, diagnosis and treatment of breast cancer in older women.

Objective: This goal of this study was to determine what percentage of women are diagnosed and treated for breast cancer within Marion County, with a primary focus on Salem, Oregon during 1998-2003. This data was analyzed to ascertain what percentage of women with breast cancer are elderly, and based on age, compare factors such as percentages of annual screening, diagnosis and treatment among the various age groups. This study aimed to draw comparisons between the age groups and to determine if older women are being under-treated in the screening, diagnosis and treatment of breast cancer.

Design: This was a retrospective chart review involving the extraction of data from the Salem Hospital Tumor Registry Database to gain an estimation of the percentages' of women diagnosed and treated for breast cancer at Salem Hospital. These findings include dates of breast cancer diagnosis, what stage at diagnosis assigned such as localized, regional to lymph nodes, in situ, and distant metastasis, with the", inclusion of known ER and HER-2/neu status if applicable, nodal dissection performed and type of treatment modality used based on age. Setting: Women within the Marion County/Salem community of Oregon who had undergone evaluation, diagnosis and treatment of breast cancer during 1998-2003. Patients or other Participants: N=1,971 female patients were extracted via the Salem Tumor Registry Database. Intervention(s): None Main Outcome Measure(s): Results: 67% were < 70 yrs of age and>33% were,>70 yrs of age, with a mean of 63.42 yrs and std. deviation of 13.395.

Conclusions: Women >70 yrs of age have more mastectomies vs. breast conservation surgery compared to women < 70 yrs of>age, thus are more aggressively treated. Women >70 yrs of age are unlikely to receive chemotherapy treatment compared to younger women < 70 yrs of age. Over the past six>years, there is an increase in breast cancer diagnosis in women < 70 years of>age, whereas women >70 yrs there is a decrease in breast cancer diagnosis suggesting the lack of breast cancer screening in this age group. Given the results, more data is needed to determine if there is a deviation in the standard of care towards older women with breast cancer or if this is a result of provider/patient preference.


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