...and over-70s wrongly denied cancer surgery

THOUSANDS of older women with breast cancer are being needlessly denied surgery that could save their lives, a study has revealed.

Women over the age of 70 can be overlooked for surgery or chemotherapy due to a misguided belief they are too frail to withstand intensive treatment.

Instead they are often given anti-oestrogen hormone therapy tablets, a less aggressive treatment for breast cancer.

But research has shown that it is appropriate for almost all older women to have surgery, which is more effective and can add years to their life.

Of the 55,000 new cases of breast cancer diagnosed each year in the UK, nearly 19,000 are in over-70s. Older women are more likely to die of the disease than younger ones, but experts say they should be offered surgery to ‘bridge the age gap in survival rates’.

Researchers at the University of Sheffield looked at 2,979 older women with breast cancer, of whom around one in five were treated only with anti-oestrogen tablets while the rest had surgery. The tablet-only group were on average eight years older than the group who had surgery. Over the next four years, 42 per cent of the non-surgery group died of any cause compared to 14 per cent of the group who had surgery.

After adjusting the results for age, stage of the tumour and other diseases, the researchers, whose findings were presented at the virtual European Breast Cancer Conference, found one in three women treated with tablets die, compared to only one in four who receive surgery.

There were also no deaths attributed to surgery and complications including heart attacks and stroke were rare. Lead author Professor Lynda Wyld said: ‘For most women, surgery is well tolerated and should be the aim of treatment if possible, as we have shown that surgery is gener ally well tolerated and survival rates are slightly lower in women who do not have surgery.’ But she added surgery is not right for everyone, particularly women who are already struggling with their health.

She said: ‘When we looked at the two treatments in a less fit group of older women, these differences in breast cancer survival disappeared. These findings suggest that for older, less fit, frailer women with hormone-positive breast cancer, hormone therapy alone is likely to be as good as surgery if their life expectancy is less than four to five years.’

Dr Kotryna Temcinaite, of Breast Cancer Now, said: ‘This valuable research could lead to a new way of assessing treatment options for older women that ensures they receive treatment that is most appropriate to them, by taking into account not only their age but also their fitness levels and their personal preferences around treatment.

‘Crucially, all women with breast cancer, regardless of their age, must be given the opportunity to discuss all treatments available to them with their clinical team so that treatment decisions are tailored around what is best for each individual.’

‘Bridge the age gap in survival’