Turning 70 may decrease a breast cancer patient’s chances of receiving postoperative radiotherapy.

Researchers at Yale Cancer Center and Northwell Health said that when comparing early-stage breast cancer patients who were 70 and 69 with a high risk of cancer recurrence, the 70-year-olds were 53% less likely to be recommended for the treatment and 39% less likely to receive it following breast-conserving surgery.

Patients aged 70 were “nearly twice as likely to be passed over for radiation” than those at 69, they said. The study is among “the first to demonstrate an age cutoff heuristic in oncology,” and based on more than 500,000 patient records.

“In breast oncology, physicians seem to anchor on a patient entering their 70s as a signal to de-escalate care, even in situations where evidence does not support this practice. Our study indicates that physicians should be mindful of how we factor age into treatment decisions and adopt a more nuanced approach, extending beyond defining patients as simply 'young' or 'elderly,'” said Dr. Wesley Talcott, lead author of the study and a radiation oncologist with Northwell Health, in a statement.

Talcott and his colleagues found no similar gaps between other year-over-year age groups.

As a patient’s lifespan shortens, recommendations for them to receive radiotherapy gradually decline. The difference in prescribing radiotherapy at 69 versus 70, they say, shows that cognitive heuristics plays a greater role in decision-making among physicians than previously thought.

“It’s important that we center individual patients, with the unique characteristics of their cancer, as well as their individual preferences, in treatment decisions,” said Dr. Suzanne Evans, FASTRO, senior author of the study and a professor of therapeutic radiology at Yale Cancer Center.

The findings were published in International Journal of Radiation Oncology•Biology•Physics.

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