Quality of Life in the Elderly Woman with Breast Cancer Treated with Tamoxifen and Surgery or Tamoxifen Alone

Abstract

Despite the fact that breast cancer risk increases with age and approximately a third of all new tumors occur in women aged 70 and above, this group of patients usually is excluded from clinical trials. Consequently, there are few data available on the quality of life of the elderly woman with breast cancer. Expectation that elderly women who had surgical treatment for their breast cancer would experience a poor quality of life was one of the primary arguments used against surgery and for the promotion of hormonal therapy alone. In the United Kingdom, 153 women taking part in the Cancer Research Campaign's Elderly Breast Cancer Trial comparing optimal surgery and tamoxifen with tamoxifen alone were sent two questionnaires, General Health Questionnaire (GHQ-28) and a sociodemographic questionnaire, at 3 months and 2 years posttreatment. Results from the GHQ-28 at 3 months showed a small statistically significant advantage to the tamoxifen alone group, but at 2 years, scores above threshold were similar for both groups. There was no evidence that early surgery significantly impaired the quality of life of elderly women with breast cancer. There was a nonsignificant trend in the data, suggesting that the continued anxiety of living with a tumor or the eventual need for surgery or both may adversely affect those women treated by tamoxifen alone.