Over-70s are wrongly denied breast cancer surgery: Thousands of elderly patients are not undergoing operations or chemotherapy due to belief they are too frail to withstand intensive treatment, new study reveals

  • Woman over the age of 70 often treatment with anti-oestrogen hormone tablets
  • It comes from misguided belief they are too frail for more intensive treatments
  • But research shows it is appropriate for almost all older women to have surgery 

Thousands of older women with breast cancer are being needlessly denied surgery that could save their lives, a study has revealed.

Women over the age of 70 can be overlooked for surgery or chemotherapy due to a misguided belief they are too frail to withstand intensive treatment.

Instead they are often given anti-oestrogen hormone therapy tablets, a less aggressive treatment for breast cancer. 

But research has shown that it is appropriate for almost all older women to have surgery, which is more effective and can add years to their life. 

Thousands of older women with breast cancer are being needlessly denied surgery that could save their lives, a study has revealed. Library image

Susan Daniels was ‘blissfully unaware’ she might have breast cancer when her mammogram was cancelled at the start of lockdown.

Susan Daniels’ mammogram was cancelled at the start of lockdown.

But two months later, she found a lump in her breast and she was diagnosed with the disease in June.

Despite missing out on screening, Mrs Daniels believes she is one of the lucky ones because she was able to get a swift diagnoses after checking her breasts.

The 60-year-old has now had surgery and is due to begin radiotherapy treatment shortly.

She said: ‘I have always attended my breast screening when invited and so when we moved to a new area I called up in March to arrange the appointment I was due.

‘When I was advised that screening was on hold due to the pandemic and that I would receive an invitation at some point in the future, it was disappointing but I understood that COVID-19 was making everything difficult. At that time though, I was blissfully unaware that I might have breast cancer.’

The Quality Manager from Glynneath, Wales, said: ‘When I was given the news I had breast cancer it was devastating and surreal at the same time.

‘In my opinion, screening is vital for early detection, as is self-checking. I cannot even begin to know the distress experienced by anyone who is still awaiting an appointment.’

Of the 55,000 new cases of breast cancer diagnosed each year in the UK, nearly 19,000 are over-70s.

Older women are more likely to die of the disease than younger ones, but experts say they should be offered surgery to ‘bridge the age gap in survival rates’.

Researchers at the University of Sheffield looked at 2,979 older women with breast cancer, of whom around one in five were treated only with anti-oestrogen tablets while the rest had surgery.

The tablet-only group were on average eight years older than the group who had surgery.

Over the next four years, 42 per cent of the non-surgery group died of any cause compared to 14 per cent of the group who had surgery.

After adjusting the results for age, stage of the tumour and other diseases, the researchers, whose findings were presented at the virtual European Breast Cancer Conference, found one in three women treated with tablets die, compared to only one in four who receive surgery.

There were also no deaths attributed to surgery and complications including heart attacks and strokes were rare.

Lead author Professor Lynda Wyld said: ‘For most women, surgery is well tolerated and should be the aim of treatment if possible, as we have shown that surgery is generally well tolerated and survival rates are slightly lower in women who do not have surgery.’

But she added surgery is not right for everyone, particularly women who are already struggling with their health.

She said: ‘When we looked at the two treatments in a less fit group of older women, these differences in breast cancer survival disappeared. 

‘These findings suggest that for older, less fit, frailer women with hormone-positive breast cancer, hormone therapy alone is likely to be as good as surgery if their life expectancy is less than four to five years.’

Dr Kotryna Temcinaite, of Breast Cancer Now, said: ‘This valuable research could lead to a new way of assessing treatment options for older women that ensures they receive treatment that is most appropriate to them, by taking into account not only their age but also their fitness levels and their personal preferences around treatment.

‘Crucially, all women with breast cancer, regardless of their age, must be given the opportunity to discuss all treatments available to them with their clinical team so that treatment decisions are tailored around what is best for each individual.’

A MILLION women miss vital breast screening: Huge backlog after coronavirus lockdown means thousands of patients could have undetected cancer… with 986,000 waiting for life-saving mammograms

By Eleanor Hayward Health Reporter for the Daily Mail 

A million women have missed out on breast cancer screening as a result of lockdown.

The huge backlog means the killer disease may have gone undetected in around 8,600 of them.

The charity Breast Cancer Now estimates that 986,000 patients are waiting for life-saving mammograms because screening ground to a halt when the pandemic struck.

Early diagnosis hugely improves survival chances and doctors warned the delays mean young and otherwise healthy women will ‘die unnecessarily’.

A million women have missed out on breast cancer screening as a result of lockdown. The huge backlog means the killer disease may have gone undetected in around 8,600 of them. Library image

The screening programme, which prevents around 1,300 deaths and detects 19,000 cases a year, was suspended for four months in March.

Today’s shocking figures highlight the catastrophic impact of the pandemic on millions of patients with conditions other than Covid-19.

‘Mammogram saved my life,’ says mother-of-two Karen King 

Going for a mammogram saved Karen King’s life.

Karen King, 49, says a mammogram saved her life

The 49-year-old ‘thanks her lucky stars’ every day for the screening programme, which caught her breast cancer last year before she had symptoms.

But the Southampton mother-of-two, pictured, now fears for the many thousands of women potentially in her position.

‘I really do worry about the backlog for women waiting for routine mammograms caused by the pandemic,’ she said.

‘I understand why screening had to be cancelled but I do know that it will have caused a lot of worry for a lot of ladies who may still be waiting for it to be rescheduled and I also have no idea if my annual mammogram will be affected when it’s due in December.

‘I honestly believe that screening, and my surgeon, saved my life by finding my breast cancer when it did as I had no symptoms. I am so lucky we have this programme.’

The Daily Mail has highlighted official data showing nearly 75,000 lives could be lost through the unintended consequences of lockdown including cancer treatment delays.

It will increase pressure on Boris Johnson to hold back on a second lockdown, with campaigners stressing that cancer care ‘cannot afford to be paused again’.

Experts warned that the NHS had an ‘enormous mountain to climb’ to clear the screening backlog.

The breast X-rays, which are an essential tool for spotting breast cancer early, are offered to women aged 50 to 71 every three years.

Although NHS screening has now resumed, many clinics have had to reduce the number of appointments because of social distancing and infection control.

The NHS is also facing a desperate shortage of diagnostic staff to carry out the checks – a quarter of health trusts have vacant breast radiologist roles.

Baroness Delyth Morgan, chief executive of Breast Cancer Now, said: ‘That nearly one million women across the UK were caught up in the backlog waiting for breast screening is cause for grave concern as we know that around 8,600 of these women could have been living with undetected breast cancer.

‘Mammograms are a key tool in the early detection of breast cancer, which is critical to stopping women dying from the disease. We cannot afford for the programme to be paused again.’

Around 55,000 cases of breast cancer are detected every year in the UK, causing 11,500 deaths.

Nine in ten women diagnosed at the earliest stage live for at least five years, compared with just 15 per cent of those diagnosed at the most advanced stage.

Between March and July, some 107,000 fewer women were referred to a specialist with suspected cases of breast cancer compared to the same period last year.

Hundreds of thousands of cancer patients have had vital scans, tests, surgery, chemotherapy or radiotherapy delayed or cancelled as a result of Covid-19.

The breast X-rays, which are an essential tool for spotting breast cancer early, are offered to women aged 50 to 71 every three years. Library image

Some of these procedures would have saved or extended lives, granting cancer patients precious extra time.

Yesterday, leaked data obtained by the Health Service Journal revealed more than 6,000 NHS patients have been waiting more than 100 days following a referral to cancer services.

The number on the cancer waiting list grew from 50,000 at the start of August to around 58,000 in the middle of September.

Mary Wilson, consultant breast radiologist and lead for the National Breast Imaging Academy Project, said: ‘To not only maintain pre-pandemic levels of activity, but also do a huge catch-up with inadequate workforce levels is an enormous mountain to climb. We desperately need more radiologists.

‘A long-term investment plan is essential.’

Karol Sikora, a consultant oncologist at the University of Buckingham, said: ‘Young, otherwise healthy women will sadly die unnecessarily because of these delays. We shut the country down for Covid – where is the Government’s urgency on this?’

A spokesman for the NHS in England said: ‘The vast majority of cancers detected through screening programmes are at a very early stage and so any impact on patients who were due to be screened is extremely low.

‘More than 200,000 people were treated for cancer during the peak of the pandemic, breast screening services are now fully up and running.’

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