Peters et al. report in their study about the management of incident breast cancer patients that patients aged >69 years received breast-conserving surgery, chemotherapy and radiotherapy significantly less frequently (1). Furthermore, even though no age-specific differences in the distribution of positive HER2/neu and hormone receptor status exist, comparatively fewer patients aged >69 years were treated with trastuzumab or hormone therapy. The article is based on data on clinical characteristics, tumor-biological findings and retrospectively conducted patient surveys on breast cancer treatment from a 2-year follow-up. Breast cancer patients without adjuvant therapy, with neoadjuvant therapy and/or with distant metastasis were excluded.
The PMV Research Group conducted a healthcare research study among breast cancer patients incident in 2010 in Germany. This study included a 2-year follow-up and was based on nationwide secondary data from the BARMER-GEK statutory health insurance (n = 6152; <50 years, 14%; 50–69 years, 53%; >69 years, 32%). Essentially, our study confirmed the age-group differences reported by Peters et al.: Patients aged >69 years received comparatively less chemotherapy (65% vs. 37% vs. 14%), radiotherapy (72% vs. 76% vs. 51%) and treatment of HER2/neu-positive tumors with trastuzumab (16% vs. 9% vs. 4%). No differences between the age-groups were identified with regard to hormone therapy (67% vs. 74% vs. 67%). The analysis of the various groups of treating physicians showed that patients aged >69 years received comparatively less care from specialists in gynecology (95% vs. 91% vs. 80%), hematology/oncology (27% vs. 18% vs. 11%) and radiotherapy (63% vs. 67% vs. 48%).
As this study is based on secondary data it has the advantage that no distortions as the result of recall bias and selection bias are to be expected. Limitations include the lack of data on clinical characteristics and treatment adherence.
The above mentioned results largely confirm the age-group differences reported by Peters et al., but provide no explanation either.
Footnotes
Conflict of interest statement
Dr. sc. hum. Rebecca Hein and Dr. rer. soc. Ingrid Schubert have received financial support from Roche for a research project they initiated.
References
- 1.Peters E, Anzeneder T, Jackisch C, Dimpfl T, Kunz G, Katalinic A, Waldmann A. The treatment of primary breast cancer in older women with adjuvant therapy—a retrospective analysis of data from over 3000 patients from the PATH Biobank, with two-year follow-up. Dtsch Arztebl Int. 2015;112:577–584. doi: 10.3238/arztebl.2015.0577. [DOI] [PMC free article] [PubMed] [Google Scholar]