Older women with breast cancer face discrimination


Published Date:
29 July 2009
By Mike Waites Health Correspondent
OLDER women are less likely to get the full range of treatment for breast cancer, a shock survey reveals today.

An audit of nearly 8,000 cases of the disease diagnosed between 2002 and 2004 also exposes massive regional differences in the way women are treated.

The results suggest that older women across Britain are less likely to receive chemotherapy, radiotherapy or surgery than younger women with a similar diagnosis.

Campaigners are today urging doctors to review their practice amid concerns of widespread age discrimination as well as a postcode lottery of care.

Regional differences were uncovered across 11 areas of Britain, particularly in whether patients had a mastectomy or less invasive breast-conserving surgery.

In the Trent region, which covers South Yorkshire, Derbyshire, Nottinghamshire, Lincolnshire, Leicestershire and Rutland, as many as 42 per cent of reported cases with an invasive breast tumour smaller than 1.5 centimetres (about half an inch) had a mastectomy rather than breast-conserving surgery.

Researchers say that, although some patients may choose to have a mastectomy, the figures are higher than can be explained through patient choice alone.

In Yorkshire and the North East, 38 per cent of patients had a mastectomy.

But in the North West only 23 per cent of patients underwent the operation and in Northern Ireland it was carried out on 19 per cent.

Guidance on the diagnosis and treatment of breast cancer from the National Institute for Clinical Excellence was published in February which sets out best practice standards of care.

Officials from the charity Breakthrough Breast Cancer, which funded the analysis, said they hoped breast units across the country would carry out a review of their practice in light of the findings.

The charity's director of policy and campaigns, Maggie Alexander, said last night: "Breakthrough is concerned that there appear to be significant differences in treatment given to patients depending on their age. While older patients may be less likely to receive standard treatment, possibly due to patient choice or the underlying health of an individual, we need to better understand all the reasons why.

"All women should be offered appropriate treatment options no matter what their age and that's why we are now investigating this issue to find out what lies behind these differences.

"We hope that healthcare professionals will use these data to consider their own services and to review any areas which differ widely from other regions or clinical guidelines."

Director of the West Midlands Cancer Intelligence Unit Gill Lawrence, who led the project, said: "By improving the quantity and quality of the information collected on the treatment of these breast cancers we can improve the quality of care for patients.

"We encourage breast units to review their services and to identify ways in which they can be improved."

Consultant breast surgeon Hugh Bishop, based in Bolton, said the data gave surgeons an "excellent" opportunity to look at how their services compared with others around the country and urged more to take part in the study.

"Collecting data on the treatment we provide is vital if we are to continue to develop and improve services," he said.

The study is published in the British Journal of Cancer.

Breast cancer is the most commonly diagnosed cancer in Britain.

About 46,000 women are diagnosed with each year with invasive breast cancer.

It accounts for nearly one-in-three of all female cancers and one-in-nine women in Britain will develop breast cancer at some point in their lives.


MAIN POINTS

Researchers from the West Midlands Cancer Intelligence Unit found:

16 per cent of patients over 65 received chemotherapy, compared to 77 per cent of those under 50.

48 per cent of women aged 80 and over did not receive any type of surgery, compared with just 3.5 per cent of women under 50.

42 per cent of women aged 65 and over had breast- conserving surgery, compared with 51 per cent of women under 65.

31 per cent of patients over 80 received radiotherapy, compared with 78 per cent of patients under 50.

My deceaed husband belonged to the American Legion. One of the members mothers had cancer and she belonged to the VFW Ladies Auxilary. When the women belongs to that they get a cancer policy that will get them very best of care. From transportatiion, room and board, the best hosiptals that offer the best care all the way down to if you need a wig. So after looking into I joined the VFW Ladies Auxilary,(but you have to be a lifetime member) which I am and now I have the cancer policy. It is real bad on my Mother's side and in 2004 I had two separate kinds at the same time.Luckley it was early but still had to have major surgeries in Pittsburgh. Right now they are watching nodules in my lungs. When I signed up we hoped I would never need it but with that stuff you never know.