Ontology highlight
ABSTRACT: Background
Older patients are poorly represented in breast cancer research and guidelines do not provide evidence based recommendations for this specific group. We compared treatment strategies and survival outcomes between European countries and assessed whether variance in treatment patterns may be associated with variation in survival.Methods
Population-based study including patients aged ≥ 70 with non-metastatic BC from cancer registries from the Netherlands, Belgium, Ireland, England and Greater Poland. Proportions of local and systemic treatments, five-year relative survival and relative excess risks (RER) between countries were calculated.Results
In total, 236,015 patients were included. The proportion of stage I BC receiving endocrine therapy ranged from 19.6% (Netherlands) to 84.6% (Belgium). The proportion of stage III BC receiving no breast surgery varied between 22.0% (Belgium) and 50.8% (Ireland). For stage I BC, relative survival was lower in England compared with Belgium (RER 2.96, 95%CI 1.30-6.72, P < .001). For stage III BC, England, Ireland and Greater Poland showed significantly worse relative survival compared with Belgium.Conclusions
There is substantial variation in treatment strategies and survival outcomes in elderly with BC in Europe. For early-stage BC, we observed large variation in endocrine therapy but no variation in relative survival, suggesting potential overtreatment. For advanced BC, we observed higher survival in countries with lower proportions of omission of surgery, suggesting potential undertreatment.
SUBMITTER: Derks MGM
PROVIDER: S-EPMC6035184 | biostudies-literature | 2018 Jul
REPOSITORIES: biostudies-literature

Derks Marloes G M MGM Bastiaannet Esther E Kiderlen Mandy M Hilling Denise E DE Boelens Petra G PG Walsh Paul M PM van Eycken Elizabeth E Siesling Sabine S Broggio John J Wyld Lynda L Trojanowski Maciej M Kolacinska Agnieszka A Chalubinska-Fendler Justyna J Gonçalves Ana Filipa AF Nowikiewicz Tomasz T Zegarski Wojciech W Audisio Riccardo A RA Liefers Gerrit-Jan GJ Portielje Johanneke E A JEA van de Velde Cornelis J H CJH
British journal of cancer 20180607 1
<h4>Background</h4>Older patients are poorly represented in breast cancer research and guidelines do not provide evidence based recommendations for this specific group. We compared treatment strategies and survival outcomes between European countries and assessed whether variance in treatment patterns may be associated with variation in survival.<h4>Methods</h4>Population-based study including patients aged ≥ 70 with non-metastatic BC from cancer registries from the Netherlands, Belgium, Ireland ...[more]