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All TopicsForum: Not Diagnosed but Worried → Topic: 86 y.o. Mother w/Alzheimers may have breast cancer

Topic: 86 y.o. Mother w/Alzheimers may have breast cancer

Forum: Not Diagnosed but Worried — Meet others worried about developing breast cancer for the first time.

Posted on: Jul 4, 2007 06:42PM

SiouxSue wrote:

They have found a lump in my 86-year-old mother's breast. It has not yet been tested because she would need to be very heavily sedated for the process, due to her Alzheimer's. The medical consensus seems to be that "we don't want to put her through it if we don't need to."

The doctor (a gerontologist, specializing in the elderly) has recommended "watchful waiting" to see what the lump does rather than rush her to a hospital for a mammogram or needle biopsy. She said that - in women mother's age - breast cancer is not usually agressive. It is NOT what will kill her, in the end.

I can find nothing on the Internet which agrees, but nothing that disagrees, exactly, either. I find no discussion about breast cancer in women over 80. Can anyone point me at research which supports that view, or says it's totally wrong? Or provides me with some additional information?

The doctor said that 86-year-old women typically die of something other than the breast cancer - it is the "loser" in the race to end her life when vying with the Alzheimer's, pneumonia, etc.

She has moderately advanced Alzheimer's - is in a wheelchair, cannot communicate effectively, cannot really understand what is said to her, and, when hospitalized for a UTI 3 years ago, needed to be sedated to keep her from pulling out the IV's.

She would need to be pretty heavily sedated to be taken (via ambulance) to an oncologist. She would need to be very heavily sedated for a biopsy or any other test to see if the lump they found is malignant. She would not understand what is going on (she cannot communicate, and everyone is a stranger to her), and it would be highly stressful to her.

My heart breaks at the though of her hospitalized, recovering from a lumpectomy or mastectomy. She would pull at dressings and tubes, resist medication, etc. It would be terrifying to her!

The horrible irony, of course, is that her body is in much better shape than her brain. Low blood pressure, low blood sugar, low cholesterol, good heart and lungs, etc.

Is the doctor right about breast cancer usually being non-aggressive in 86 year old women? Does anyone else have any experience with this kind of situation? Log in to post a reply

Posts 1 - 14 (14 total)

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Jul 4, 2007 07:25PM Shirlann wrote:

As you might have already figured out, this is a very difficult "grey" area for the medical field. Simply finding out what type of lump your mom has makes sense to me. This is not too invasive and her lump could well be a cyst or one of many other things that breasts grow that are not malignant.

Now the hard part. If the lump does not appear (as best they can tell) to be a cyst or a fibroadenoma, what to do next? A fine needle aspiration is not too bad, and that might give them answers. They can often tell if her lump is a cyst with an ultra sound. This is easy on her too.

Now, if the lump "fails" the ultrasound test, or in other words, it is a solid lump versus a fluid filled cyst, then they normally do a biopsy of some type.

This is where they are conflicted. If they find out it is cancer, is it in your mom's best interests and her families best interests to pursue aggressive treatment at her age? You and the family and her too should have the right to decide this. Treatment can be a simple lumpectomy, or, removal of the actual tumor. Cancer or not, leave it at that. Or, of course, if it is cancer and it has spread to the lymph nodes (a not so easy surgery to remove these) does she and you all want to remove the lymph nodes. Then, normally, chemotherapy is done with radiation treatments to follow.

Now, it may be that just removal of the lump and when the results come back as to her Progesterone, Estrogen status, she can be reasonably treated with hormone therapy. That is Tamoxifen. This is a pill. The girls that take this will be on soon to tell you if it has side effects and how severe they can be.

Putting her through chemo at her age in her condition is the tough one. I am afraid you and her and the family will have to decide.

I am so sorry this has entered your life and we will all pray for a simple cyst that can be found on ultrasound and left alone.

Gentle hugs, Shirlann
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Jul 4, 2007 08:08PM iodine wrote:

I agree with her doctor. Most lesions in older women are NOT agressive and have been present for 8-10 years before they have even been identified.

It's one of those things, if you test it what do you do with the results? If you are not going to treat it agressively, why test it?

Example: I had an orthorpedic problem and the doc recommended I get an MRI. I asked why, she said that we could do a joint surgery. I said I wouldn't agree to surgery on my shoulder joint, so there was no reason to get the study. Why waste the resource of time and money on the MRI if I was not going to do anything with the results.

Just to say I knew what was there? I already knew I had a problem and thru physical exam, we pretty well knew what it was, so the testing was just a back up.

I agree that with your Mom's condition and the stress she would be put under, watchful waiting would be much more appropriate for her that putting her thru a lot of testing just to "know".

It's tough to make decisions for others,especially those you love. But you have made it clear to me how much stress your mom would be put thru just to get her to the hospital, let alone get testing done. I feel for you and wish you the best in your decision making.

Just my 2 cents, and probably not worth that.

Dotti---BE NOT AFRAID, Pope John Paul

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Jul 4, 2007 08:17PM Toronto wrote:

My MIL is about 86 and her good friend of roughly the same age has a breast lump. They are doing the waiting thing with her, will check again in 6 months. This woman is not in great health, but she certainly is mentally acute and she's okay with waiting and watching.

Seems that this lump isn't giving her problems and dealing with it would. If it were my mother I'd vote for the "watchful waiting".
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Jul 6, 2007 08:10AM wallycat wrote:

My mother is going to be 84 and has a lot of mental health issues (though not Alz.) and they found vaginal bleeding.
They started to run a lot of tests and finally she is refusing.
I said to go by what she wants (even if she is not mentally able to decide the outcome of her situation) because she is ultimately the one who knows how much pain and stress she is willing to endure at this stage of the game.
She has other health issues and I tend to agree, something else will get her before cancer does.
For my peace of mind, I know her quality of life has not been the greatest with all she is dealing with and she has been wanting to die since she was 50. I am leaving things be.
Sometimes the kindest things we can do are the hardest to carry out.
I wish you and your mom much peace.

Dx 4/07 1 month before turning 50; ILC 1.8cm, ER+/PR+, HER2 neg., Stage 1, Grade 2, 0/5 nodes. Onco score 20, Bilateral Mast., tamoxifen 3-1/2 years, arimidex-completed 4/20/2012

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Jul 8, 2007 03:22AM aussiejan wrote:

My Mum has Alzheimer's and my sister and I have discussed what to do if Mum were diagnosed with something in light of my own breast cancer. We both agreed that whatever is to happen with Mum will not involve any medical intervention aside from keeping her pain free.
The loss of dignity already experienced by Alzheimer's patients is already great enough. Forcing her into diagnostic tests would be obscene because, like your mother, she would not understand what is happening.
While you and I both want to do the best by our mothers, the question needs to be asked "For whose benefit are these tests being conducted?". That you are questioning invasive testing for your mother would indicate that you already have the answer.
I do wish you well in your decision making.
Dx 9/20/2006, IDC, 2cm, Stage IIa, Grade 2, 1/16 nodes, ER+/PR+, HER2-
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Jul 8, 2007 04:18AM Sierra wrote:

SiouxSue:

I am sorry to read about your
Mom and her DX.

Really do not know what advice to put
forth

I would share that:
My aunt is 80 and had a masectomy
(recently)
doing quite well

Another v. good friend
84 doing chemo, rads
started with BC (now ovarian)
but might leave it (very hard
on her now)

My Mom is late eighties
does a form of chemo orally
and some dementia I notice
now, the medication can be
so hard when people age
(combined meds especially)

It is all very sad

I send out healing and hope that
you can arrive at a decision
that works the best for your Mom
and your family. Certainly, not an
easy one.

These are all very special people to me
I can well understand how you feel,
difficult situation indeed

Hugs and Bright Light
being sent to you today

The Time is Now!

Dx 1/2000, 3cm, Stage IIb, Grade 3, 1/14 nodes, ER-/PR-
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May 23, 2012 11:27PM daughterof86 wrote:

Hey this is similar to my mum, also 86.  Not diagnosed totally but 4 cm lump, so ultrasound shows a cyst with possibly cancer in it. The GP said they will give her oral chemotherapy. I asked about the side effects, Oh, she said, they're not much , its oral... Then I read the side effects of oral chemotherapy on the internet and freaked out.  I saw  a top sydney specialist today. He said at her age and with her conditions  he would put her on tamoxifen and some hormone therapy. I asked what if it has spread? Same strategy he said. The idea is to stop it where it is. What about side effects of tamoxifen: None, he says, only some flushing. I hope this helps

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May 23, 2012 11:40PM camillegal wrote:

My aunt was dianosed with cancer at 82 and she has the onset of altz. and they did nothing--My cousins thought why--she doesn't even realize she has it and she was fine for another 7 yrs. and did not die of cancer. So that's what I know

Dx 2007, Stage IV, 24/38 nodes, HER2+
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May 24, 2012 01:17AM Mazy1959 wrote:

Sue, about a year ago a relative of my bro in law died at age 85. At age 81 she had alzheimers, heart probs and breast cancer ( very large tumor). They opted not to do surgery and she lived like that for more than 4 yrs. The family discussed it at length with all her doctors and as much as they could with her. The way they saw it was what good would it do to put her thru a masectomy etc etc. She was in no pain and although her mind wasnt right..she had emotions and could hold small conversations. Hope this helps. Hugs, Mazy

Bone marrow mets in 90% of bone marrow.

Dx 3/6/2003, ILC, 3cm, Stage IIb, Grade 2, 2/9 nodes, ER+/PR+, HER2-Dx 12/19/2006, ILC, 4cm, Stage IV, Grade 2, 0/0 nodes, mets, ER+/PR-, HER2-Dx 4/25/2012, ILC, Stage IV, Grade 2, 0/0 nodes, mets, ER+/PR+, HER2-Dx 8/4/2012, ILC, Stage IV, Grade 2, 0/0 nodes, mets, ER+/PR+, HER2-Chemotherapy 08/09/2012 Abraxane
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May 24, 2012 06:26AM marie5890 wrote:

Sue,

To the basic question of is the doctor telling you the truth that breast cancer tends to be not be aggressive in older women?

Yes, that is true.

I have a loved one with Alzhiemers. And I know quite alot about BC for a layperson.

If *I* were in your shoes, I would do exactly what the Dr.'s are recommending. In someone your mother's age, BC tends to be very slow in growing.... 

DO NOT READ ANYTHING INTO THE TECH'S EXPRESSION OR WHAT THE TECH SAYS. Jan '11 Biopsy Dx-ed a PASH tumor (rare, but benign tumor)....All I ask is for peace and serenity to the depths of my soul. Makes the rest of life more live-able.

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May 24, 2012 07:51AM itsjustme10 wrote:

My friend's grandmother had the same thing happen.  She was in her late 90's, failing both physically and mentally at that time, and they found a lump when she was hospitalized.  In her case, they wanted to biopsy and all that.  My friend's mother looked at them and said "tell me exactly how that will improve the length or quality of her life".  Crickets...

 If your mother could communicate, what do you think she would want to do?  Do you think she's happy being how she is now, and knowing it's only going to progress?  Do you think she would want physically and mentally debilitating treatments for what would probably be little or no additional quality time on earth? 

Listen to the doctor, don't torture yourself.  It's the humane thing to do.

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May 24, 2012 09:18AM marie5890 wrote:

(just realized this is an old thread from '07 that got bumped by daughterof86. Daughterof86, my reply would be the same as it was to Sue. Sorry about that)

DO NOT READ ANYTHING INTO THE TECH'S EXPRESSION OR WHAT THE TECH SAYS. Jan '11 Biopsy Dx-ed a PASH tumor (rare, but benign tumor)....All I ask is for peace and serenity to the depths of my soul. Makes the rest of life more live-able.

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May 24, 2012 10:53AM, edited May 24, 2012 10:53AM by ICanDoThis

Daughter of 86

This is hard. My MIL was in her early 80s when she discovered a lump and refused all treatment. She had no dementia, she was just a nice stubborn Southern lady. Then I got pregnant with her first and only grandchild, and she went on tamoxifen.

She really had no additional side effects - already had dreadful arthritis, so she had no additional pain in joints, no problems with hot flashes (later, I would also have none of these problems with tamox).

And it gave her several additional years to see her granddaughter. We have some lovely pix, and my daughter remembers her, although only vaguely.

Sue - Proud to be Krista's Mom

Dx 12/28/2007, IDC, 1cm, Stage I, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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May 24, 2012 05:05PM coraleliz wrote:

 I remember my cute FIL becoming confused from Alz disease & sincerely asking to be put on Hospice. He eventually was believed to have "cancer" but it was never worked up because his poor mental capacity. My friends aunt was recently diagnosed with stage 1/grade 1 BC at age 84. She had a lumpectomy & completed the Canadian protocol for radiation. She refused hormonal(aromatase inhibitor or tamoxifen) & chemo is seldom considered for stage 1 grade 1 even in younger women. Not saying that this is what your family member has. I think it would be too hard for a person with alz disease & is uncoperative to pursue treatment. Even adding hormonal therapy(I think that's what's meant by oral chemo here) may actually decrease her quality of life. Many many younger women complain(myself included) about side effects. Your mom can't complain. You might explore "palliative" care. Many patients even without cancer go that route. We went that route with my mom when she developed dementia related to a neuological condition. I lost my when her mind quit working, not when her heart quit beating. Just my thoughts. I know others won't agree.

Dx 2/28/2011, IDC, 1cm, Stage II, Grade 1, 2/4 nodes, ER+/PR+, HER2-