Women over 70 undergoing breast cancer treatment should be formally assessed for frailty to ensure treatment decisions are justified, experts say.
A new audit of care has found major variations in care of women with oestrogen positive tumours. Overall auditors found women in their 70s were much less likely than women in their 50s to undergo surgery.
There were also wide variations in the care of women over the age of 75, auditors found.
Auditors said there was no evidence that older women experience a more benign disease than younger women.
The National Audit of Breast Cancer in Older Patients has now developed fitness assessment form to be used at the time of the patient’s first consultation.
Breast surgeon Professor Kieran Horgan, who led the investigation, said: “Worryingly, the audit showed that apparently fit older women were less likely to undergo surgery if they had an oestrogen positive breast cancer tumour. There could be valid reasons why some patients did not have surgery. If, for example, a patient had heart disease, it could increase the risks of them having complications from a general anaesthetic.
"However, it is vital that there is equity of care for older people, particularly with regards to assessing a person’s suitability for surgery. This must be done by examining an individual’s fitness and not purely be based on chronological age.”
https://www.nabcop.org.uk/reports/nabcop-2020-annual-report/
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