Article Abstract

Older breast cancer undertreatment: unconscious bias to undertreat—potential role for the international geriatric radiotherapy group?

Authors: Nam P. Nguyen, Ulf Karlsson, Eromosele Oboite, Julio Alvarenga, Juan Godinez, Alice Zamagni, Micaela Motta, Satya Bose, Vincent Vinh-Hung


The prevalence of breast cancer increases with age. Older breast cancer patients often present with locally advanced disease at presentation because mammography, which diagnosed early stage disease, is not recommended after the age of 75. In addition, they are often undertreated even when they are physically fit and have non-metastatic disease. As a result, survival is often poor. Physicians bias may be a factor in their undertreatment and lack of representation in prospective clinical trials. Physicians should be educated that chronological age is not a contraindication to curative treatment for older breast cancer patients. As a research group devoted to older cancer patients, women, and minorities, the International Geriatric Radiotherapy Group (IGRG) plans to conduct prospective trials to assess biomarkers for frailty, the controversial issue of mammography for older breast cancer patients, and the incorporation of frailty index for curative breast cancer treatment. The data obtained may help to decrease physician bias and to establish future guidelines for older breast cancer patients treatment.