‘Age bias’ hits older breast cancer patients

‘They assume they are more afraid’

OLDER breast cancer patients may be advised against surgery due to doctors’ ‘age bias’, researchers have warned.

Despite guidelines to treat breast cancer patients ‘irrespective of age’, older women experience different treatment and worse outcomes than younger patients, according to a study.

Although survival rates for the disease have almost doubled in the past 40 years, the greatest gains have been seen in younger patients. To find out why, researchers from Brighton and Sussex Medical School asked 31 breast surgeons and specialist nurses to complete a set of questions about treatment in different age groups.

Their findings, published in the European Journal of Surgical Oncology, said: ‘Breast cancer health care providers were less likely to recommend surgery for older patients.

‘Some assumed older patients are more afraid, less willing and able to be involved in decisionmaking, and less willing and able to cope with a poor treatment prognosis. This indicates elements of age bias among breast cancer health care providers.’

One possible reason for the survival gap could be a bigger tendency to use primary endocrine therapy (PET) rather than elective surgery on older patients compared with younger ones.

Professor Malcolm reed, an expert in breast cancer management in older women, told the Guardian: ‘In the UK up to 40 per cent of older breast cancer patients are treated with PET alone, despite evidence that elective surgery in many of these patients is safe.

‘Some [age bias] is unconscious, but a lot of it is based on what [clinicians] genuinely feel is best for these patients, but is not necessarily completely in line with the evidence.’

Since the 1970s there has been a 57 per cent reduction in breast cancer mortality rates for patients aged 25 to 49, a 50 per cent reduction in 50 to 64-year-olds, and a 44 per cent decrease for 65 to 69-year-olds. For 75 to 79-year-olds it has only dropped by 27 per cent, while those aged 80 and above have recorded a 6 per cent increase.