[Trends in breast cancer treatment in the elderly at a breast cancer outpatient clinic: guidelines followed better].
OBJECTIVE
To investigate the treatment of resectable breast cancer in elderly patients at Alkmaar Medical Centre, Alkmaar, the Netherlands, before and after the introduction of a multidisciplinary breast cancer consultation (MDC) with the breast cancer team in February 2006.


METHODS
Retrospective.


METHODS
The treatment of patients aged 70 and over with newly diagnosed stage I and II resectable breast cancer was monitored during the period 2002-2007.


RESULTS
A total of 84% of the 232 studied patients were treated surgically. Adjuvant treatment with radiotherapy, hormone therapy and chemotherapy was given to 88, 91 and 5 patients, respectively. The percentage of patients who underwent first-line surgery decreased significantly, mainly because fewer patients aged 80 or over received surgery. The number of patients given radiotherapy in accordance with guidelines increased, while for hormonal therapy the number remained more or less the same. Recording of decisions that involved deviation from treatment guidelines improved in the study period.


CONCLUSIONS
In 2002-2007, the breast cancer team became more aware of treatment guidelines and deviations from guidelines were better accounted for. In the elderly, the guidelines for adjuvant radiotherapy were followed better, but there was a remarkable decrease in primary surgical treatment of patients, particularly in patients aged 80 and over. Comorbidity and patients' preferences played an important role in this.
Hamaker
Marije E
ME
Afd. Interne Geneeskunde, Medisch Centrum Alkmaar, Alkmaar, The Netherlands. marije.hamaker@gmail.com
Schreurs
W Hermien
WH
van Slooten
Henk Jan
HJ
Uppelschoten
Jeroen M
JM
Smorenburg
Carolien H
CH
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D018567:Breast Neoplasms, Male / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D011878:Radiotherapy / Q000639:trends; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal