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Standard treatment of female patients with breast cancer decreases substantially for women aged 70 years and older: A German clinical cohort study
Annals of Oncology, 10/19/09

Hancke K et al. – Our study confirms that substandard treatment increases considerably with age. Omission of radiotherapy had the greatest impact on OAS and DFS in the elderly population.

• 1922 women aged 50 years with histologically confirmed invasive breast cancer treated at University of Ulm from 1992 to 2005 enrolled
• Adherence to guidelines and effects on OAS and DFS for women aged 70 years compared with that for younger women (50-69 y)

• Women > 70 years less often received recommended breast-conserving therapy (70–79 years: 74%–83%; >79 years: 54%) than women aged 69 years (93%)
• Non-adherence to guidelines on radiotherapy (< 70 years: 9%; 70–79 years: 14%–27%; > 79 years: 60%) and chemotherapy (< 70 years: 33%; 70–79 years: 54%–77%; > 79 years: 98%) increased with age Omission of radiotherapy
• Omission of radiotherapy significantly decreased OAS [69 years: hazard ratio (HR) = 3.29; ≥ 70 years: HR = 1.89] and DFS (≤ 69 years: HR = 3.45; P < 0.0001; ≥ 70 years: HR = 2.14)
• OAS and DFS did not differ significantly for adherence to surgery, chemotherapy, or endocrine therapy

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