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Poor breast cancer survival rates in older women linked to fewer axillary dissections. (Understaged, Inadequate Tx).
ORLANDO, FLA. -- Older women who had breast-conserving surgery without axillary dissection were almost twice as likely to die from their breast cancer within 7 years as women who received either axillary dissection, radiotherapy, or both in a large retrospective cohort study.
As women become older, they are less likely to be treated for occult breast cancer, Dr. Xianglin Du said at a meeting of the Department of Defense Breast Cancer Research Program.
Although reasons for this trend remain unclear, "it could explain, in part at least, why we have seen no improvement in the survival of older women with breast cancer over the past 20 years," Dr. Du said.
The lower rates of axillary dissection in this group lead to understaging of the disease, inadequate treatment, and poorer outcomes, he added.
Dr. Du's retrospective cohort study matched breast cancer treatment with outcome for more than 31,000 women who were aged 25 years and older; the cases were drawn from two large national databases.
Twenty-seven percent of those women received breast-conserving surgery (BCS) without axillary dissection; 74% of that group was 65 years or older.
This group was also undertreated with both radiotherapy and chemotherapy, said Dr. Du of the University of Texas, Galveston.
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