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Breast Cancer screening and treatment after 80

12% of breast cancer is in women over 80 years old.  No one would argue the importance of screening for breast cancer using mammograms.  The survival rate is very high with early detection, and early death can be reduced by 15 percent in women over 50. 

However, as women age, many live with obesity, high blood pressure, high blood sugar, or heart disease.  Their life expectancy is lower whether breast cancer is discovered or treated.  Some women suffer from arthritis or stroke that prohibits them from walking or moving objects at home.  These are both indicators of how helpful breast cancer treatment is based on their quality of life. For women with dementia or if they are mentally ill, the consideration for breast cancer screening and treatment may not improve their life expectancy or quality.

The tool to calculate life expectancy is https://eprognosis.ucsf.edu/cancer/partials/breast-cancer.php

It is a tool using current medical research to help doctors determine the meaningfulness of a treatment and screening test.  

Some of the factors can definitely be changed, some can not. For example, an 80-year-old woman can improve her BMI by losing weight, and exercising.  If her orthopedic surgeon can improve her quality of life by minor surgery, but she did not want to. She may now put that into consideration to improve her ability to walk well, and to exercise more.  Quitting smoking is definitely a factor that improves this calculation of prognosis.  

We don't truly know how long each of us will live, and this prognosis calculator certainly can not.  It serves as a medical decision-making tool and guide, based on what we currently know in science.  Make an appointment with us if you are facing a challenging decision, and let us help you through a telemedicine consultation.

This is a review article if you would like to learn more about this topic. https://reader.elsevier.com/reader/sd/pii/S0378512217310940?token=BB9C13BC18ABD2014FED1DD8E5C9C5593AD47ECB6EED1B1C6610A24F582437BD705577E0FE9F43C5C645ED3852978A7F&originRegion=us-east-1&originCreation=20230102174903

SHAWN HAMILTON, MD, MBA Internal medicine physician with 20 year of experience as PCP.

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