Treatment & survival of older breast cancer patients: an international comparison between the Netherlands and Ireland

Elderly breast cancer patients in Ireland are less likely to have ‘guideline’ loco-regional treatment, but more likely to have hormone therapy or chemotherapy, than in the Netherlands.

About 40 per cent of all new breast cancer cases in developed countries occur among women aged 65 and older. Despite this, guidelines about optimal treatment for breast cancer lack evidence for treatment of older patients. This collaborative study, recently published in the journal PLOS ONE, aimed to compare treatments and relative survival for breast cancer in the elderly between the Netherlands and Ireland, using cancer registry data from each country.

In this age-group, patients with less advanced cancer (stage I-III) were more likely to have appropriate breast surgery, radiotherapy and lymph-node investigation in the Netherlands than in Ireland. On the other hand, elderly patients in Ireland were more likely to receive endocrine therapy or chemotherapy than equivalent patients in the Netherlands.

Relative survival for Irish patients was poorer, even after taking into account differences in tumour characteristics. However, it was not possible to determine if this reduced survival was a result of specific treatment differences. 

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