EDITOR—The paper by Kroman et al on factors influencing the effect of age on prognosis in breast cancer has important implications for service delivery,1 increased amounts of chemotherapy being required for young women. The authors imply that only women at high risk received adjuvant chemotherapy. In all, 36.3% of their 867 patients under 35 were in the low risk group, an excess mortality being associated with not receiving chemotherapy.

We used the Yorkshire Cancer …