By Dr. Aldo Moran, Market Medical Director, Flagship Health

Every October, we shine a light on breast cancer with stories of survivorship, advancements in care, and reminders that awareness saves lives. Much of this messaging is geared toward younger and middle-aged women. But breast cancer can affect women in the later stages of life, and it’s no less important to address. For those aged 64 and beyond, understanding risk, recognizing symptoms, and navigating care options are vital steps toward maintaining health and independence.

At Flagship Health, we know that every stage of life brings unique needs. For older adults, breast cancer care isn’t just about treatment—it’s about ensuring that every decision reflects personal goals, overall well-being, and quality of life.

Breast Cancer and Aging

Breast cancer is one of the most common cancers among women in the United States. Yet the conversation often overlooks the age group most affected: older adults. The likelihood of developing breast cancer increases steadily with age, driven by natural changes that occur over a lifetime.

As the body ages, DNA damage gradually accumulates, hormones fluctuate after menopause, and the immune system becomes less efficient at repairing or destroying abnormal cells. Together, these factors contribute to the higher incidence of breast cancer in later years.

Recent data highlight this connection between aging and breast cancer:

While the rate appears to decline slightly in women over 85, this may reflect competing health conditions or less frequent screening rather than reduced risk. The takeaway is clear: age remains one of the strongest predictors of breast cancer. For older women, continued awareness and personalized screening decisions are essential for early detection and better outcomes.

Why Breast Cancer Risk Rises with Age

Age affects the body in countless ways, and many of these changes influence cancer development. Over time, the body’s cells undergo billions of divisions, leaving more opportunities for mutations that can trigger cancer. Hormonal changes also play a role. After menopause, the drop in estrogen and progesterone alters how breast cells grow and respond to signals, while a lifetime of hormone exposure contributes to overall risk.

Additionally, the body’s ability to repair DNA damage and eliminate abnormal cells decreases with age. The immune system becomes less vigilant, and the breast tissue itself undergoes changes that can make cancers harder to detect early. Chronic conditions such as diabetes, high blood pressure, or obesity may further increase risk through inflammation and metabolic stress.

Understanding these biological shifts is the first step in recognizing why breast health remains an essential part of aging well.

Unique Treatment Considerations for Older Adults

When it comes to treating breast cancer in older adults, there is no one-size-fits-all approach. Two women of the same age may have entirely different health profiles. One may be active and robust, while another may live with multiple chronic conditions. That’s why treatment for seniors must balance medical effectiveness with a person’s individual needs, tolerance, and goals.

1. Physiological Differences and Tolerance
Older adults often have less physical “reserve,” meaning the body takes longer to recover from stress. Treatments such as surgery, radiation, or chemotherapy can place additional strain on organs like the heart, kidneys, and liver. Side effects such as fatigue, infections, dehydration, or neuropathy can have a greater impact on daily living and independence.

Because of these differences, your care team may adjust medication doses, alter schedules, or choose therapies that minimize toxicity while maintaining effectiveness. What’s crucial is to make these adjustments based on medical assessment, not age alone. Your primary care provider plays a key role in managing these factors, and can work closely with specialists to ensure your care remains well-coordinated and focused on you. 

2. Surgery, Radiation, and Hormone Therapy
Many older adults are excellent candidates for surgery, but risks like slower wound healing or anesthesia reactions must be considered. Less invasive procedures may be preferred when appropriate. Radiation therapy can also be effective but may cause fatigue and skin irritation—issues your primary care team can help monitor and manage.

Hormone (endocrine) therapy is commonly used for older women whose breast cancers are hormone receptor-positive. These medications are often better tolerated than chemotherapy but can cause joint pain, bone thinning, or cardiovascular effects, which your provider will monitor closely over time.

3. Balancing Treatment and Quality of Life
In senior care, the guiding principle is balance—maximizing both longevity and well-being. Aggressive treatments that severely affect quality of life may not always be the best choice. Instead, treatment plans should align with what matters most to you, whether that’s maintaining independence, spending time with family, or pursuing certain life goals.

A Personalized Approach: Treating the Whole Person

No two older adults are alike. Some are active and healthy well into their 80s and 90s, while others live with multiple medical conditions or mobility challenges. That’s why individualized care is so important. 

At Flagship Health, we perform comprehensive health assessments that go beyond the cancer diagnosis. We look at your overall function, cognition, nutrition, social support, and day-to-day independence to guide care decisions. This whole-person approach helps identify strengths, anticipate challenges, and ensure that treatment plans are both effective and manageable.

Shared decision-making is a key part of our process. That means having open discussions between you, your family, and your care team about your priorities, values, and comfort level with different options. When your voice is heard and respected, the highest level of care is possible. 

What You Can Do 

Your primary care team is your first line of defense against breast cancer. Here are a few steps you can take now that can make a big difference in protecting your health.

  • Stay proactive. Ask your primary care provider whether mammograms or other screenings are still recommended for your age and health status.

  • Report changes early. If you notice any new lumps, nipple changes, skin dimpling, or discomfort, schedule a visit promptly.

  • Ask about your care plan. If you’re diagnosed with breast cancer, request a coordinated approach that includes your primary care provider alongside specialists.

  • Focus on what matters to you. Talk openly about your goals and preferences. Your primary care team will help design a plan that fits your life.

Staying Strong, Supported, and Informed

Breast cancer in older adults is not a rare condition—it’s a growing reality in an aging population. But it’s also a story of resilience, adaptability, and progress. Advances in medicine have made it possible for older women to live longer, fuller lives after diagnosis.

This Breast Cancer Awareness Month, let’s broaden the message of awareness to include every generation. With education, individualized care, and compassionate support, older adults can continue to live with purpose, dignity, and strength.

At Flagship Health, we’re here to help you navigate every step of your health journey. Because your best years deserve your best care. 

To schedule an appointment to learn more about our senior health services, contact us today.

About Dr. Aldo Moran

Dr. Aldo Moran is the Market Medical Director for Flagship Health in San Antonio, Texas. He earned his Doctor of Osteopathic Medicine from Nova Southeastern University and completed his Internal Medicine Residency at the University of the Incarnate Word in Laredo, Texas. Before his medical career, Dr. Moran served seven years in the U.S. Army, including deployment during Operation Iraqi Freedom, where he was an infantry squad leader and the Non-Commissioned Officer in Charge of Nuclear, Biological, and Chemical Defense operations. Fluent in English and Spanish, he has been practicing since 2019, focusing on diabetes and metabolism disorders, cardiovascular disease prevention, and preventive medicine.