Results from the largest international comparison of the treatment of elderly patients with breast cancer show that significant differences exist in the use of surgery, hormone therapy and chemotherapy between European countries.
The European Registration of Cancer Care (EURECCA) study compared the treatment of elderly patients (70 years or older) in Belgium, Ireland, The Netherlands, Portugal, Poland and the UK. Patients were diagnosed with non-metastatic (stage I, II or III) breast cancer between 2000 and 2014. The researchers also compared the number of patients who were alive after five years of their diagnosis.
The results of the study were presented by Dr Marloes Derks (MD), a PhD student at the Department of Surgery in the Leiden University Medical Center (Leiden, The Netherlands), at the 2015 European Cancer Congress.
"Based on a comparison of data from Belgium, Ireland and The Netherlands, surgery was omitted most frequently in older patients with stage III breast cancer. The omission of surgery was lowest in Belgium at 15%, followed by The Netherlands at 28% and the highest was in Ireland at 37%," said Dr Derks.
She also highlighted that differences in the use of hormone therapy and chemotherapy in Belgium, Ireland, The Netherlands, Portugal and Poland varied substantially depending on the stage of cancer. Use of adjuvant hormone therapy in older patients with stage I disease was lowest in The Netherlands at 21% but in Ireland, Belgium, Portugal and Poland, its use varied between 82-88%. Use of chemotherapy was lowest in The Netherlands (at 9 percent) for all stages of breast cancer in elderly patients as compared to 26 percent in Ireland, 30 percent in Belgium, 58 percent in Portugal and 78 percent in Poland.
Dr. Derks suggested that these differences may exist because of a lack of evidence for the treatment of older patients with breast cancer. She hoped these results would create more awareness and would also pave the way for future research so that evidence-based guidelines could be developed for treatment of elderly patients with breast cancer. She also pointed out that the survival data suggests that elderly patients in Belgium and Ireland have better relative survival as compared to The Netherlands.
Source: ECCO-the European CanCer Organisation
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