Older women diagnosed with breast cancer in England are less likely to survive their disease than those in Belgium, Poland, Ireland, and the Netherlands according to research published today in the British Journal of Cancer.

In one of the largest studies of its kind looking at breast cancer patients aged 70 and over, researchers found that England ranked worst out of the selected countries for 5-year survival for breast cancer at stage 2 and 3.

The team, based at the Leiden University Medical Centre in The Netherlands, analyzed the anonymized records of 236,015 women who’d been diagnosed with breast cancer before it had spread.

They also found patients with stage 1 or 2 breast cancer in England are most likely to have no surgery as part of their treatment compared with other countries.

Not having surgery at stage 3 was found to be linked to poorer survival. In England, 44% of patients received no surgery at stage 3, compared to 22% of patients in Belgium.

Overall, the number of patients with stage 3 breast cancer surviving their disease for 5 years or more in England (48%) was 12% lower than in Belgium (60%).

Author, Dr. Marloes Derks, said: “The fact that breast cancer mortality in England is higher than in other countries in this study, even for those women whose cancer is in its earliest stage, suggests there is something more at play than just a failure to diagnose it early.”

“We were surprised to see England had lower levels of breast cancer surgery, and further research is needed to establish whether these two factors are linked.”

Professor Arnie Purushotham, senior clinical adviser at Cancer Research UK, said: “We know that surgery is one of the most effective treatments for breast cancer so it’s vital that women in England aren’t missing out on surgical treatment that could save their lives.

“We need to better understand why patients in England are less likely to have surgery than their European counterparts. Surgery should be considered in all older patients who are fit to undergo this treatment.”

“While the thought of an operation might sometimes be daunting, breakthroughs in surgical techniques have meant that for many patients a lumpectomy with minimal surgery to the armpit glands can be just as effective as more radical treatment.”