Elderly breast cancer care 'poor'

Researchers from the University of Manchester found they are less likely to get a range of diagnostic tests and treatments.

Writing in the British Journal of Cancer, they say this is likely to lead to higher rates of cancer recurring, and higher death rates.

Cancer campaigners said women of all ages deserved high standards of care.

"This is related to their age rather than differences in the biology of their tumour"
Dr Katrina Lavelle, University of Manchester

The highest incidence of breast cancer in England occurs in women aged 70 and over.

They also have a lower chance of surviving the disease - women aged 70-79 have a 76% chance of surviving for five years after their illness, compared to 80% for all ages.

This drops to 61% for women aged 80 or over - a fall which is not explained by their increase in age.

Perceptions 'differ'

The team reviewed the cases of 480 women aged 65 and over, who lived in Greater Manchester, with invasive breast cancer registered over a one year period.

They found that a woman aged 80 or over was over five times less likely to receive a triple assessment - where the lump is assessed, a mammogram is taken and cell and tissue studies - to say if her cancer is operable, compared to a woman aged 60 to 65.

Her odds of her not receiving surgery are more than 40 times higher.

And they say even women in their early 70s are over seven times less likely to get radiotherapy following surgery, compared to women aged 65-69 years.

The researchers say the variations in care are not explained by differences in their tumours.

And they suggest the findings can be applied nationally because there is little variation in breast cancer survival between regions.

A survey of UK breast cancer surgeons in 2004 found three quarters said they would treat older breast cancer patients in a similar way to younger patients, while 98% said the cut off point for breast cancer surgery was not age related.

However Dr Katrina Lavelle, who led the Manchester research, said: "Women aged 70 and over are less likely to receive the same breast cancer care as younger women and that this is related to their age rather than differences in the biology of their tumour.

"Clearly there is a difference in clinicians' perceptions of how older breast cancer patients should be treated and their actual practice."

She added: "Mortality of elderly breast cancer patients is unlikely to improve where this pattern of management persists."

Dr Sarah Rawlings, of Breakthrough Breast Cancer: "All women should have access to the best possible services and treatments for breast cancer, regardless of age.

"Although breast cancer risk increases with age, older women are more likely to underestimate their chances of developing the disease and may also present with the disease at a later stage, which may affect the treatment options available.

"The earlier breast cancer is caught, the better the chances of successful treatment."

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Breakthrough Breast Cancer
British Journal of Cancer
University of Manchester
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