Addressing Age-Related Disparities in Breast Cancer Treatment: Insights with Tabby Khan, MD

November 1, 2025

Disparities in Advanced Breast Cancer Treatment Access Revealed in New Analysis

New York, NY – A recent study highlights significant inequalities in access to antibody-drug conjugate (ADC) treatments for patients with metastatic breast cancer. The analysis,conducted by healthcare intelligence firm Komodo Health and the Tigerlily Foundation,a breast cancer advocacy group,indicates that age and insurance coverage play a critical role in determining who receives these possibly life-extending therapies.

Rising Incidence and Treatment Rates

Data shows a concerning trend of increasing metastatic breast cancer diagnoses in the United States. Between 2001 and 2021, the incidence climbed from 5.8 to 7.9 cases per 100,000 women. Concurrently, utilization of ADC treatments surged 3.7-fold from 2021 to 2023. Fortunately, the time to initiate treatment decreased substantially, dropping from 331 to 109 days during the same timeframe.

Age and Insurance: Key Barriers to Care

Despite the overall improvements in treatment access,stark disparities persist. The study revealed older women face disproportionately lower treatment rates-2557 per 100,000-and substantially longer delays, with a median wait time of 242 days. Moreover,patients covered by Medicare experienced the lowest rates of ADC treatment compared to those with commercial or Medicaid insurance. This suggests a systemic challenge in ensuring equitable access to cutting-edge therapies for vulnerable populations.

Insurance Type	treatment Rate
Commercial	Highest
Medicaid	Second Highest
Medicare	Lowest

Racial Disparities and Emerging Trends

Interestingly, the analysis uncovered a positive trend: Black women demonstrated higher rates of ADC treatment compared to White and Asian women. Researchers attribute this to the elevated prevalence of triple-negative breast cancer within the Black community, a particularly aggressive form of the disease often requiring more intensive treatment strategies.

Did You Know? Triple-negative breast cancer accounts for approximately 10-15% of all breast cancers, and is more common in younger women and African Americans.

Leveraging AI to Address Disparities

Komodo Health utilized its Health Care Map, encompassing data from over 330 million patients, alongside its AI platform, Marmot, to quantify these disparities on a large scale. Dr.Tabby Khan, senior Director of Analytics at Komodo Health, emphasized the need to proactively address barriers to treatment for older adults. “We have to continue to counsel these patients and also providers on why this may be a realy good option for women in that age group,” she stated.

pro Tip: Patients should actively discuss all treatment options with their oncologist, including ADCs, and advocate for timely access to care.

Understanding Antibody-Drug Conjugates (ADCs)

Antibody-drug conjugates represent a significant advancement in cancer therapy. These targeted treatments combine the specificity of antibodies with the potency of chemotherapy drugs, delivering a powerful payload directly to cancer cells while minimizing damage to healthy tissue. ADCs have shown promising results in treating various types of cancer, including HER2-positive and triple-negative breast cancer.

The future of cancer treatment likely involves increasing reliance on personalized medicine and targeted therapies like ADCs, making it even more critical to address disparities in access and ensure all patients benefit from these innovations.

Frequently Asked Questions about Breast Cancer Treatment

• What are antibody-drug conjugates? ADCs are a type of targeted therapy that combines antibodies with chemotherapy drugs to selectively kill cancer cells.
• Are ADCs suitable for all types of breast cancer? ADCs are currently approved for specific subtypes of breast cancer, such as HER2-positive and triple-negative.
• Why do older patients experience delays in treatment? Potential factors include age-related health conditions, logistical challenges, and differences in treatment protocols.
• Does insurance coverage affect access to ADC therapy? Yes, insurance coverage, particularly Medicare, can significantly impact a patient’s ability to receive ADC treatment.
• How can disparities in cancer care be addressed? Addressing disparities requires a multi-faceted approach, including improving access to healthcare, promoting awareness, and addressing systemic biases.
• What is triple-negative breast cancer? Triple-negative breast cancer is a type of breast cancer that lacks estrogen receptors, progesterone receptors, and HER2 protein, frequently enough requiring more aggressive treatment approaches.
• Where can I learn more about breast cancer resources? The American Cancer Society (https://www.cancer.org/) and the National Breast cancer Foundation (https://www.nationalbreastcancer.org/) offer valuable facts and support.

What steps can be taken to improve access to advanced cancer treatments for all patients? Share your thoughts in the comments below!

How does Dr. khan’s geriatric oncology specialization inform her approach to breast cancer treatment compared to a conventional oncology perspective?

Understanding the Landscape of Breast Cancer in Different Age Groups

Breast cancer isn’t a single disease; its presentation, aggressiveness, and response to treatment vary substantially based on a patient’s age. While frequently enough associated with older women, breast cancer does occur in younger individuals, and treatment approaches need to be tailored accordingly. Dr. Tabby Khan, a leading oncologist specializing in geriatric oncology, emphasizes the critical need to move beyond a “one-size-fits-all” approach to breast cancer care. Age-related physiological changes, comorbidities, and treatment preferences all play a role. We’ll explore these nuances, focusing on age and breast cancer, breast cancer in older adults, and younger breast cancer patients.

Physiological Changes & Treatment Tolerance

As women age, their bodies undergo changes that impact how they tolerate cancer treatment. These include:

* reduced organ Function: kidney,liver,and heart function naturally decline with age,affecting drug metabolism and increasing the risk of side effects from chemotherapy,radiation therapy,and even targeted therapy.

* Decreased Bone Density: Osteoporosis is common in postmenopausal women. Certain breast cancer treatments, like aromatase inhibitors, can further exacerbate bone loss, increasing fracture risk. Bone health is a crucial consideration.

* Comorbidities: Older adults are more likely to have pre-existing conditions like heart disease, diabetes, and arthritis.These co-morbidities can complicate treatment decisions and possibly interact with cancer therapies.

* Cognitive Impairment: Age-related cognitive decline can impact a patient’s ability to understand treatment options, adhere to medication schedules, and report side effects accurately.

Dr. Khan notes,”We need to carefully assess a patient’s overall health status before initiating treatment. A comprehensive geriatric assessment can help identify vulnerabilities and guide treatment planning.” This assessment frequently enough includes evaluating functional status, nutritional status, and psychological well-being.

Treatment Modifications for Older Adults

Given these physiological changes,treatment plans for older adults often require modification. This doesn’t necessarily mean less treatment, but rather smarter treatment.

* De-escalation Strategies: In some cases, less aggressive treatment approaches may be appropriate, particularly for hormone receptor-positive, HER2-negative breast cancers. This might involve omitting chemotherapy or using lower doses.

* Prioritizing Quality of Life: Maintaining quality of life is paramount. Treatment decisions should consider the patient’s goals and preferences, focusing on symptom management and functional independence. Palliative care integration is often beneficial.

* Modified Surgical Approaches: Consideration of less invasive surgical options, such as lumpectomy with sentinel lymph node biopsy, can minimize recovery time and complications.

* Supportive Care: Aggressive management of side effects, including fatigue, nausea, and pain, is essential. This may involve medications, physical therapy, and nutritional support.

The Unique Challenges of Young Breast Cancer Patients

Younger women (under 40) diagnosed with breast cancer face a different set of challenges. Their cancers tend to be more aggressive, often diagnosed at later stages, and are more likely to be triple-negative. Triple-negative breast cancer is particularly challenging due to its lack of targeted therapy options.

* Fertility Preservation: Many young women are concerned about the impact of treatment on their fertility. Discussing fertility preservation options, such as egg freezing, before starting chemotherapy is crucial.

* Genetic Predisposition: Younger women are more likely to have a genetic predisposition to breast cancer, such as mutations in the BRCA1 or BRCA2 genes.Genetic testing is recommended.

* Psychological Impact: A breast cancer diagnosis at a young age can be particularly devastating, impacting body image, relationships, and future life plans. Psychosocial support is vital.

* Different Treatment Goals: Treatment goals may differ.While older adults may prioritize quality of life, younger patients might potentially be more willing to accept aggressive treatment options to maximize their chances of long-term survival.

Dr. Khan explains,”younger patients frequently enough require more intensive treatment regimens. However, we must also be mindful of the long-term side effects of these treatments, such as cardiac toxicity and secondary cancers.”

The role of clinical Trials

Clinical trials offer access to cutting-edge treatments and can be particularly beneficial for both older and younger patients. Dr. Khan actively encourages her patients to consider participating in trials. “Trials are essential for advancing our understanding of breast cancer and developing more effective treatments. They can provide hope and potentially improve outcomes.” resources like ClinicalTrials.gov can help patients find relevant trials.

Benefits of a Geriatric-Focused Approach to breast cancer

Implementing a geriatric-focused approach to breast cancer treatment yields several benefits:

* Improved Treatment Tolerance: Minimizing side effects and maximizing treatment adherence.

* Enhanced Quality of Life: Maintaining functional independence and overall well-being.

* Reduced Hospitalizations: Proactive management of comorbidities and side effects.

* Better Patient Satisfaction: Shared decision-making and personalized treatment plans.