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Seven days in medicine: 13-19 June 2018

BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k2685 (Published 21 June 2018) Cite this as: BMJ 2018;361:k2685

Cancer

Older women are less likely to have breast surgery

Only 76% of women over 70 with breast cancer had surgery, compared with 96% aged 50-69, showed an audit of women who had the condition diagnosed in England and Wales in 2014-16.1 Chemotherapy rates also varied with age: around 60% of women aged 50-69 had chemotherapy, compared with 23% of women over 70 with ER negative disease and 28% of those with HER2 positive disease, showed figures from the National Audit of Breast Cancer in Older Patients.

Rationing reconstructive breast surgery is “totally unacceptable”

One in five clinical commissioning groups (22.6%; 47 of 208) in England has a policy to restrict NHS breast reconstruction services for non-clinical reasons, and a further nine (4.3%) have draft policies or informal restrictions, the charity Breast Cancer Now found.2 Policies include limiting the number of operations women are allowed, enforcing a time frame on their completion, and denying “balancing surgery” to the unaffected breast to achieve symmetry with the reconstruction. The charity urged commissioning groups to ensure that all patients have access to the reconstructive services they need.

Children’s long term cancer survival continues to improve

The trend for improvement in five year survival among all cancers in children combined has continued, increasing from 77.1% in 2001 to 84.0% (predicted) in children with cancer diagnosed in 2017, the Office for National Statistics found.3 One year and 10 year survival improved in all ages from 0 to 14 and was considered most likely to be caused by improvements in …

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