1. ¹School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
2. ²School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
3. ³North West Cancer Intelligence Service (NWCIS), Central Manchester PCT, Manchester, UK
4. ⁴CRUK Department of Medical Oncology, Christie Hospital NHS Trust, Manchester, UK
5. ⁵Withington Hospital, South Manchester University Hospitals NHS Trust, Manchester, M20 2LR, UK
6. ⁶School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK

Correspondence: Dr K Lavelle, E-mail: katrina.j.lavelle@manchester.ac.uk

Received 4 December 2006; Revised 28 February 2007; Accepted 28 February 2007; Published online 27 March 2007.

Abstract

Evidence suggests that compared to younger women, older women are less likely to receive standard management for breast cancer. Whether this disparity persists once differences in tumour characteristics have been adjusted for has not been investigated in the UK. A retrospective cohort study involving case note review was undertaken, based on the North Western Cancer Registry database of women aged 65 years, resident in Greater Manchester with invasive breast cancer registered over a 1-year period (n=480). Adjusting for tumour characteristics associated with age by logistic regression analyses, older women were less likely to receive standard management than younger women for all indicators investigated. Compared to women aged 65–69 years, women aged 80 years with operable (stage 1–3a) breast cancer have increased odds of not receiving triple assessment (OR=5.5, 95% confidence interval (CI): 2.1–14.5), not receiving primary surgery (OR=43.0, 95% CI: 9.7–191.3), not undergoing axillary node surgery (OR=27.6, 95% CI: 5.6–135.9) and not undergoing tests for steroid receptors (OR=3.0, 95% CI: 1.7–5.5). Women aged 75–79 years have increased odds of not receiving radiotherapy following breast-conserving surgery compared to women aged 65–69 years (OR=11.0, 95% CI: 2.0–61.6). These results demonstrate that older women in the UK are less likely to receive standard management for breast cancer, compared to younger women and this disparity cannot be explained by differences in tumour characteristics.