h, increased age is frequently associated with the application of less aggressive cancer treatments (7:2502). At present, there is some disagreement over how best to treat elderly women with breast cancer. Part of this controversy may result from some commonly held misconceptions.
The first of these widely held misbeliefs is that the initial presentation of cancer in elderly patients is typically more locally advanced (5:108). One study, Singletary et al. (1993), found that this assumption may be at least partially true. The researchers did observe that a large proportion of women seeking a diagnosis for symptoms of breast cancer had fairly well advanced disease. They also noted that it is often the women themselves who are blamed for this state. The researchers suggested though, that perhaps the medical profession is also partly responsible. Singletary and colleagues postulated that delays in diagnosis among this population may contribute to the advanced nature of the patients' disease.
Such hypotheses, however, contrast directly with the results of other studies. In a review of 3,558 patients with breast cancer, Mueller and colleagues (1978) found that stage I lesions were equally common in all age groups (2:657). In addition, Herbsman et al. (1981) found that the tumors of elderly patients tended to be more localized. Furthermore, while investigating advanced stages of the disease, Hunt et al. (1980) obtained data which might indicate that a nonmetastasizing form of breast cancer is peculiar to the elderly.
Each of these investigations suggests that breast cancer in elderly patients does not generally present at a more advanced stage than breast cancer in younger patients (2:657). This could result from any number of factors. Perhaps the most plausible explanation, however, is the fact that people over the age of 65 tend to visit their physician more frequently tha
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