De behandeling van oudere en van jongere postmenopauzale patiënten met mammacarcinoom verschilt, hun overleving niet

– The effect of age on choice of treatment and on survival was studied retrospectively in 611 breast cancer patients aged 55 years and older from the Netherlands Cancer Institute (NKI, 1981-1986) and in 2268 patients with a similar age distribution from southeast North-Brabant and north Limburg (SOOZ region, 1975-1987). In both regions patients of 75 years and older received postoperative adjuvant radiotherapy less often than younger patients. In the SOOZ region, treatment of elderly patients more often consisted of limited surgery, followed by hormonal therapy if necessary, while in the NKI tamoxifen alone was used more often. In addition, the response rate to tamoxifen was studied in 85 patients from the NKI and Dr. Daniel den Hoed Cancer Centre. Response rate to tamoxifen was low (37.6), and relapse rate was high (42). Compared with findings in the NKI, patients of 75 years and older in the SOOZ region appeared to have stage I and II tumours less often and stage IIIB tumours more often than younger postmenopausal women. The 10-year relative survival for women of 75 years and older was significantly worse than that for younger women in the SOOZ region. Stage-specific relative survival was, however, similar in all age groups. In the NKI, women above 74 years had a significantly poorer disease-specific survival than younger postmenopausal patients. In neither region did the less extensive treatment of elderly women above 74 years appear to have a negative influence on survival.