Declined guideline adherence in older breast cancer patients: a population-based study in the Netherlands.
Publication year
2011Source
The Breast Journal, 17, 3, (2011), pp. 239-45ISSN
Publication type
Article / Letter to editor
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Organization
Health Evidence
Surgery
Medical Oncology
Former Organization
Epidemiology, Biostatistics & HTA
Journal title
The Breast Journal
Volume
vol. 17
Issue
iss. 3
Page start
p. 239
Page end
p. 45
Subject
NCEBP 1: Molecular epidemiology ONCOL 5: Aetiology, screening and detection; ONCOL 2: Age-related aspects of cancerAbstract
Older women with primary operable breast cancer might receive suboptimal care due to their advanced age. Although several studies reported age as an independent determinant for receiving none or less treatment according to accepted standards, prospective data are lacking. This study evaluates the adherence to a consensus protocol in unselected women aged 80 years and older in the Netherlands. Data were derived from the Dutch population-based Cancer Registry held by the Comprehensive Cancer Centre East. In this study all female patients, 60 years and older, diagnosed with breast cancer TNM stage I-IIIa in the period 2001 until 2006 were selected. Applied treatment according to the Dutch guideline was compared for different age groups. Differences between age groups were evaluated using a chi-square test. In total, 2336 breast cancer patients were studied. Treatment adherence was significantly lower for surgery, radiation therapy and systemic therapy in women aged 80 years and older, and all modalities were applied much less frequently, except for endocrine therapy which was more frequently applied in the oldest old. This study shows a sharp decline in guideline adherence for unselected women aged 80 years and older with primary operable breast cancer, with an observed shift from appropriate locoregional treatment toward endocrine therapy. Whether this approach is justified or not should preferably be tested prospectively.
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- Academic publications [238441]
- Faculty of Medical Sciences [90373]
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