Mastectomy and Follow-Up

QUESTION: My 73-year old mother has recently had a mastectomy to remove
breast cancer. I'm surprised at the little amount of follow-up care that has
been recommended by her doctor. It seems to me that friends around my age
(mid-50's) who've had mastectomies have had to go for more follow-up exams.
Does this sound right to you? Except for the breast cancer, my mother has led
an extremely active and healthy life.
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ANSWER: You question addresses a problem subject that has received some
careful analysis in recent research.
A recent study has found that elderly patients with breast cancer have
been given less comprehensive therapy than younger cancer victims. Doctors at
the University of California reviewed information of breast cancer patients in
7 California hospitals. They found that there were significant differences in
the way the disease was managed in patients over 70 years old.
The study found less than 64 and one-half percent of patients over 70
received appropriate care. That's compared to almost 82 and one-half percent
of patients aged 50 to 69 who obtained more thorough treatment.
Its time for you to get involved in your mother's care. Start with a
visit to her present physician, and present your concerns. There may be some
legitimate explanations that may satisfy you about the extent of the care. If
not, have your mother see another physician. Go with her and present your
problems to the new physician. You have the right and responsibility to
question the doctor to make sure she's getting appropriately aggressive
treatment.
During the study, significant differences were found between those under
70 and those over 70 with regard to the frequency of lymph node examination.
22% of the older patients did not get nodal examinations, whereas only 6% of
the younger patients did not receive the lymph node tests. So you see, there
are differences in care, and you deserve to get the best for your mother, if
you take the right actions.