Age as a predictor of diagnostic and initial treatment intensity in newly diagnosed breast cancer patients.

Newly diagnosed breast cancer patients (N = 494) aged 45-90 years were studied to determine if age was associated with appropriate diagnostic and prognostic evaluations, and initial definitive therapy. Women 75 years of age and older were less likely to receive an appropriate diagnostic evaluation than were younger women, but age was not associated with an appropriate prognostic evaluation. Older patients with local disease who were undergoing lumpectomy were less likely to receive follow-up radiation; older patients with regional disease undergoing mastectomy were less likely to receive adjuvant chemotherapy (including hormonal therapy). Physicians' attitudes about appropriateness of therapy appear to be the major determinant of what treatment is received.