Mortality from breast cancer is falling in all age groups; in 1999, case- fatality rates were about one-fifth lower than in the mid-1980s. The reasons for this are not certain, but earlier diagnosis through screening and improvements in treatment, particularly greater use of adjuvant therapies, undoubtedly contribute. 3 Five-year survival rates are highest among people aged 50-59 at diagnosis; both younger and older patients have a lower survival rate (Figure 2). However, better outcomes among women in this particular age-group could be an illusion created by lead-time and length biases associated with screening. Older people, who are generally less fit, tend to receive less aggressive treatment and this may.
