I had a first annual mammogram, ultrasound and oncologist's physical exam last week and no cancer was detected. Or am, at least at the moment, seemingly cancer-free. I did not take aromatase inhibitors (or chemo or radiation) but did have a low 'risk of recurrence' score on the OncotypeDX test.

I have two friends, also over 60, who had stage 1 tumors removed as lumpectomies who also declined to take aromatase inhibitors after receiving low risk scores on the OncotypeDX. One had cancer 5 years ago and the other 3 years ago. Neither has had a recurrence though only time will show if that cancer-free state holds. But that's true for everyone including those who 'do everything possible' to prevent a recurrence.

According to my breast cancer surgeon, older women are increasingly less likely to take the drugs. Especially if genomics testing suggests a low risk of recurrence. Another factor that plays into the decision for older women, in addition to quality of life and possible commorbitity factors, is the thought that cancers tend to progress more slowly in older women so the whole risk/reward analysis is different.

There are few valuable statistics for this demographic as older women have only relatively recently being routinely screened and early breast cancers identified. So it's an area for breast cancer research to explore and, maybe, new guidelines will be proposed for older women. The NCCN modified its radiation recommendations for certain early stage cancers in women over 70 and likely other 'standard recommendations' are being reviewed.