There are also NCCN guidelines, which one oncologist I saw referred to that don't exactly recommend no radiation for older women with low-stage cancer lumpectomies but suggest that skipping it be considered a viable, accepted protocol.

I kidded my breast surgeon, asking if this is just another economic triage idea (as recommended by Ezekial Emmanual and Cass Sunstein who advocate severely cutting funding for health care for the elderly) and she laughed, being in her late 50s.

And said that it's more a function of three things: there is very, very little data in breast cancer in older women since, until recently, routine mammograms in their case were not even offered; breast cancers in the elderly tend be less virulent and grow considerably more slowly; and the majority of women in that age group have comorbities and other health issues that can increase the risks of poorer outcomes.

She added that a lot of healthy active women also concentrate more on quality of life ("remaining years') issues and are far less likely to willingly tolerate side effects of various treatments.

All of that makes sense to me, variables that affect younger womens' decisions are viewed differently by older women with maybe a differing package of responsibilities.

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