What You Should Know About Breast Cancer in Older Adults

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Cancer is a disease commonly contracted by the elderly, with a median age of 65 years or older. Among the common cancers, women are diagnosed with breast cancer, and more than half of them are diagnosed at the age of 60 years old. 

According to the World Health Organization, breast cancer caused an estimated 670,000 deaths globally in 2022. It occurs in every country in the world and was the most common cancer among women in 157 out of 185 countries in 2022. Contrary to popular belief, breast cancer can also occur in men. Approximately 0.5-1% of breast cancers occur in men, while 99% occur in women. 

In 2025, the National Cancer Institute recorded an estimated 316,950 new cases of breast cancer and 42,170 estimated deaths. The extent of cancer in the body determines the survival rate and treatment options of a person. If the cancer is only found in the part of the body where it started, the stage is localized. On the other hand, it is regional or distant if it has spread to different parts of the body. 

Breast Cancer and Older Adults

As a person gets older, the risk of developing cancer gets higher. Most women aged 55 and older are diagnosed with breast cancer. The most common breast cancer in older adults is invasive ductal carcinoma or IDC, where the abnormal cells growing in the lining of the milk duct change and invade breast tissue beyond the walls of the duct. This is followed by the invasive lobular carcinoma or ILC, which is the second most common type of breast cancer, and it starts in the glands of the breast that produce milk. 

Risk Factors

The average American woman’s risk of developing breast cancer during her lifetime is 12.9% based on the current incidence rates (number of new cases diagnosed each year). In an article by the National Cancer Institute, an American aged 60 has a 1 in 28 (3.54%) risk of being diagnosed with breast cancer, and those aged 70 have a risk of 1 in 24 (4.09%). However, the cancer risk of an individual may be higher or lower depending on other factors.

A health professional can estimate a woman’s risk of developing breast cancer by using the Breast Cancer Risk Assessment Tool (BCRAT), also known as the Gail Model. 

The following are the risk factors for breast cancer:

1. Personal history of breast cancer or benign breast disease

Women who have a personal history of breast cancer are likely to get it for a second time. There is also an increased risk of developing breast cancer for some noncancerous breast diseases, such as lobular carcinoma in situ and ductal hyperplasia.

2. Inherited risk of breast cancer

Women with first-degree relatives (mother, sister, or daughter) who have breast cancer are at increased risk of having the same. A relative who had breast cancer at a young age or having family members on either side of the family with breast cancer can also contribute to increasing the risk. 

3. Older age

As a woman gets older, the risk of getting breast cancer increases. Most of them are diagnosed after the age of 50 years old.  There is a lower chance of dying from breast cancer among women aged 50 to 69 years old who have screening mammograms. Screening mammograms decrease the risk of breast cancer by identifying cancer early. 

4. Reproductive history resulting in greater exposure to estrogen

Estrogen is a hormone made by the body, but it increases the risk of breast cancer after being exposed to it for a long time. Early menstruation, starting menopause at a later age, and older age at birth of first child or not giving birth at all increase the risk. 

5. Dense breast tissue

It is hard to see tumors on a mammogram for women with dense breasts, so they have a higher risk of breast cancer. This is often an inherited trait, but may also occur in women who drink alcohol, women who have not had children, women who have a pregnancy late in life, and women who take postmenopausal hormones. 

6. Radiation therapy to the breast or chest

Women who had radiation therapy to the breast or chest before age 30 have a higher risk of breast cancer later in life, and it starts 10 years after the treatment. The risk largely depends on the woman’s age and on the dose of radiation that they were given. 

7. Taking hormone therapy for symptoms of menopause

Women who started taking estrogen therapy close to the time of menopause have a higher risk of developing breast cancer. Even if the taking of estrogen is stopped, the risk of breast cancer does not decrease. Taking a combination hormone therapy, another kind of therapy that combines estrogen with progestin, also increases the risk of breast cancer. In comparison to estrogen therapy, the risk of breast cancer decreases when combination hormone therapy is stopped.  

8. Obesity

Obese or overweight older women have a higher risk of getting cancer as opposed to women of a healthy weight.

9. Drinking alcohol

According to studies, excessive alcohol intake can increase the risk of breast cancer. 

Breast Cancer Stage Groups

There are three types of breast cancer stage groups. It is based on the size and location of the primary tumor, the tumor grade, the spread of cancer to nearby lymph nodes or other parts of the body, and the presence of certain biomarkers. 

Clinical Prognostic Stage

This stage group is used first to assign a stage for all patients based on physical exam, health history, imaging tests, and biopsies. It is described by the TNM system, tumor grade, and biomarker status. In this stage, ultrasound or mammography is used to check the lymph nodes for signs of cancer. 

Pathological Prognostic Stage

This stage group is used for patients who have surgery as their first treatment. It is based on biomarker status, clinical information, and laboratory test results from the lymph nodes and breast tissue removed in surgery.

Anatomic Stage

This stage group is based on the size and spread of cancer as described by the TNM system. The TNM system is used to describe the size of the primary tumor and the spread of cancer to nearby lymph nodes or other parts of the body. For breast cancer, the TNM stands for: 

• Tumor (T) is the size and location of the tumor.

• Lymph node (N) is the size and location of the lymph nodes where cancer has spread.

• Metastasis (M) is the spread of cancer to other parts of the body.

Treatment

The treatment plan for breast cancer patients depends on many factors, such as the patient's overall health, stage and grade of cancer, presence of certain biomarkers, and preference of the patient. The types of treatment used are surgery, chemotherapy, radiation therapy, hormone therapy, targeted therapy, and immunotherapy.

Older adults respond to treatment differently. Patients over 75 years old, regardless of their breast cancer subtype and prognosis, do not always receive the appropriate treatment. This can be attributed to the lack of available data in older adults with cancer and the improper assessment of functional age. 

This shows that there is a need for more research to create evidence-based guidelines in breast cancer treatment in older adults. 

To learn more about breast cancer, visit the National Cancer Institute website. 

Read more health-related articles from Ca Care Association here.