Multiple studies have demonstrated that treatment for women with breast cancer

differs substantially by patient age, with older women more likely to receive
substandard therapy.

The reasons for these differences in patterns of care of older patients are probably
multifactorial and may include a higher rate of patient comorbidities, poorer
performance status, less social support, difficulty with transportation,
patient or family preference, concerns about quality of life, lower life
expectancy, and age bias.

n addition, because so few research studies have included older women, the lack
of data may lead to less aggressive care. Studies that have examined the
predictors of surgery and adjuvant radiation have found that chronologic age was
associated with substandard therapy independently of performance status or
comorbidities, suggesting that physicians may be undertreating healthy older
women.3–5,9,15,22 Similarly, the few studies that have evaluated predictors of adjuvant
chemotherapy use have found age to be inversely associated with chemotherapy
use, after considering comorbidities.15,18 However, most of these studies have been
limited to a single treatment modality and have lacked complete individual patient
information on patient demographics, comorbidities, tumor characteristics, and
details of treatment.