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3 BIG Questions: Dr. Grace Makari-Judson

3 BIG Questions: Dr. Grace Makari-Judson Three-Big---Makari-Judson-Graceoped.jpg

Breast cancer and older women

      Dr. Grace Makari-Judson is interim vice president and medical director, Cancer Services, and interim chief, Division  of Hematology-Oncology for the Baystate Regional Cancer Program. She is also a professor of medicine at UMass Chan Medical School – Baystate. She is co-director of The Rays of Hope Center for Breast Cancer Research and serves on the Rays of Hope Community Advisory Board.            

      Makari-Judson received her medical degree from Cornell University Medical College in New York and completed a residency in Internal Medicine followed by a fellowship in Hematology/Oncology both at The New York Hospital. For over 33 years at Baystate, she has served as a breast oncologist providing quality, compassionate care for women.  She is the co-author of “Coping with Chemotherapy and Radiation,” published in 2005 by McGraw-Hill, which explained for readers what to expect at the time of treatment, making them better prepared to face side effects and to effectively alleviate them.

      When Prime wanted to ask questions about older women and beast cancer, we could think of no one better to turn to.

      Here are Prime’s questions, and Makari-Judson’s answers:

Q: Routine screening for breast cancer now begins around age 40. Is there ever an upper age limit to this exam?

“There is no upper age limit for screening mammograms, rather the decision to stop screening should be based on a woman’s overall health and her risk of breast cancer. Women with genetic risk or prior diagnosis of breast cancer may continue screening longer.

      “ Mammograms should be discontinued if a woman’s life expectancy is less than 10 years. If an individual becomes frail, there is no benefit to screening.”

Q: The incidence of breast cancer diagnosis increases as women age, reaching 1 in 29 for women between  60 to 70 years of age. What do women in this age group need to know about treatment?

      “Breast cancer treatment is personalized based on the cancer characteristics and an individual’s health. There are excellent, effective treatment that include not only surgery and radiation, but chemotherapy, immunotherapy, targeted treatments and hormone therapies that are available to all ages.”

Q: What else should older women know about breast cancer detection and treatment as they age?

      “At Baystate, we meet weekly to review the multidisciplinary management of newly diagnosed individuals with breast cancer.

      “We will look at the individual’s age and overall health and discuss whether or not surgery can be more limited, whether radiation course can be shortened or even omitted and what medical treatments are needed.

“These decisions are all interrelated and it is best when the team makes a recommendation together taking into account a patient’s overall goals.”