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Older Breast Cancer Patients often get neglected Researchers at the University of Manchester have found that older women with breast cancer get a lower level of care and often neglected when compared to younger women.

It was found that older women with breast carcinoma (cancer) were less likely to be diagnosed via triple assessment and needle biopsy than younger women. It was also found that the older women are less likely to undergo breast surgery and receive radiotherapy than their young counterparts. These are some of the possible reasons why mortality is higher in older women with breast cancer.

These findings were presented by Dr Katrina Lavelle, who led the study at the University’s School of Nursing, Midwifery and Social Work.

From News-Medical.Net:

The highest incidence of breast cancer in England occurs in women aged 70 years and older. Older women also experience the worst survival – women aged 70-79 have a 76% five-year relative survival compared to 80% for all ages, and for women aged 80 plus this drops considerably to 61%, beyond what might be expected owing to an increase in age.

The team carried out a retrospective cohort study involving case note review based on the North Western Cancer Registry database of women aged 65 and over, resident in Greater Manchester with invasive breast cancer registered over a one year period. The results of the study, funded by an NHS R&D Training Fellowship, may be generalized nationally as variation in survival between regions is lower for breast cancer compared to other cancers.

The they found that, compared to women aged 65-69 years, women aged 80 plus with operable breast cancer have increased odds of not receiving triple assessment, not receiving primary surgery, not undergoing axillary node surgery and not undergoing steroid receptor tests (which indicate suitability for hormone therapy). Compared with her 65-69-year-old counterpart, the odds of a woman aged 80 or older not receiving triple assessment for operable breast cancer are five-and-a-half times higher, and the odds of her not receiving surgery are more than 40 times higher. Even women as young as 70-74 have over 7 times the odds of not receiving radiotherapy following breast conservation surgery compared to women aged 65-69 years.

In addition, the team discovered that the overall percentage of women in all the age groups not receiving steroid receptor tests was high at 41%, which resulted in treatment decisions being taken without this fundamental information. Three quarters of the patients who did not receive steroid receptor tests were given the hormone therapy, tamoxifen: that is, prescribed a treatment without evidence that it would work.

Dr. Lavelle remarked that there is a clear difference in perceptions of many clinicians when it comes to the treatment in relation with older women with breast cancer.

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