Date Published: 16 February 2011

Late diagnosis of breast cancer in elderly women (UK)

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Women over the age of 70 years are being diagnosed with breast cancer at a later stage leading to lower survival from the disease in the elderly, according to recent research released on 16th Feb 2011.

The study, published in the British Journal of Cancer, also found that older breast cancer patients were less likely to receive the same level of treatment as younger patients. Scientists said that improving access to treatment, in particular surgery, among the elderly could significantly improve their breast cancer survival. They found that it was also important for women to report any symptoms to their GP as soon as they noticed them and be aware they could continue to have access to screening.

The research analysed over 14,000 women diagnosed with breast cancer between 1999 and 2007 from Eastern Cancer Registration and Information Centre (ECRiC) and looked at five and ten-year survival for patients in four different age groups.

The results showed that women diagnosed with breast cancer between 50 and 69 years had an 89% chance of surviving their disease for five-years. This fell to 81% for women aged 70-74 years old and to 70% for women over 80 years. 3% of women in the 50-69 age group were diagnosed with breast cancer at a late stage. These women would have been routinely invited for a mammogram every three years through the national screening programme. In comparison, 8% of women aged 70-74 and 10% of women over 80 had a late stage diagnosis. Women diagnosed at a late stage had a 14% chance of surviving their disease for five-years.

Dr Paul Pharoah, a Cancer Research UK-funded scientist and one of the study's authors based at the University of Cambridge, said:

" This study suggests that improving the way breast cancer is diagnosed and treated in the elderly could mean fewer die prematurely from the disease.
_ The national breast screening programme is very good at picking up cases of breast cancer in 50-70 age group it is aimed at.
_ But more needs to be done to raise awareness of the disease in older women who are not automatically invited for mammograms, especially since risk of the disease increases with age."

The research also suggested that older women did not always receive the same level of treatment for breast cancer as younger patients.

Around 96% of women aged 50-69 years old had surgery for breast cancer, but this fell to around 60% for women over 70.

Dr Pharoah said that factors like patient preferences, suitability and other illness could explain the differences in treatment ? but only to a certain extent. He added that more detailed diagnoses of breast cancer in the elderly could ensure that older women suitable for treatments like surgery, chemotherapy and radiotherapy received them.

Sara Hiom, director of health information at Cancer Research UK, said:

" We know that older people are less likely to survive breast cancer - this study highlights that many factors are at play and that late diagnosis and varying access to treatment, in particular, are playing a key role.
_ Late diagnosis in the elderly could also be down to women delaying a visit to the doctor, so it's really vital that women are aware of breast cancer symptoms.
_ After they turn 70, many women assume that breast cancer is less of a risk because they are no longer invited for screening but this isn't the case.
_ More must be done to ensure that older women are well informed about their breast cancer risk, their option to ask for a mammogram and are consistently offered a full range of treatment options where this might benefit them.
_ Further work needs to be done to understand why there are these large differences in breast cancer survival between older and younger women so that we can work to ensure that this gap is closed."

Reference to Paper:
Ali, A MG et al., Patient and tumour characteristics, management, and age-specific survival in women with breast cancer in the East of England, British Journal of Cancer (2011)

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