Variations in compliance to quality indicators by age for 41,871 breast cancer patients across Europe: A European Society of Breast Cancer Specialists database analysis

Objective: The aim of this study is to assess age-specific compliance to quality indicators (QIs) regarding the treatment of breast cancer as defined by European Society of Breast Cancer Specialists (EUSOMA) for patients across Europe. Methods: All patients entered into this study were affected by in situ or invasive breast cancer, diagnosed and treated between 2003 and 2012 at 27 Breast Units across Europe, who were entered into the EUSOMA database. Patients were categorised according to age; compliance to thirteen QIs was assessed for each age group and per time period (2003-2007 and 2008-2012). Compliance to QIs was tested by multivariable logistic regression models adjusted for breast unit, incidence year and tumour characteristics. Results: Overall, 41,871 patients with a mean age of 59.6 years were available for analysis. The highest compliance was reached for patients aged 55-64 years and in the time period 20082012, whilst the lowest compliance was observed for women aged over 74 or under 40 years and in the earlier time period. In multivariable logistic regression models, a significant difference between age categories was shown for 12 out of 13 QIs (P < 0.001). Compliance to the QIs for patients aged >= 75 years was significantly lower when compared to patients aged 55-64 years for ten QIs, whilst for patients in the youngest age group this was true for seven QIs. Conclusion: In conclusion, we found that among the 27 included breast units across Europe, compliance to QIs for breast cancer treatment is often lower in the youngest and oldest breast cancer patients, with a tendency to overtreatment in the youngest patients, and to under-treatment in the elderly. (C) 2015 Published by Elsevier Ltd.