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This research programme developed a fitness stratified decision tool to establish treatment thresholds and indicated that standard care was appropriate for the majority of fitter women aged 70 years or above.

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Lynda Wyld 1,2,*, Malcolm WR Reed 3, Karen Collins 4, Sue Ward 5, Geoff Holmes 5, Jenna Morgan 1,2, Mike Bradburn 6, Stephen Walters 6, Maria Burton 4, Kate Lifford 7, Adrian Edwards 7, Kate Brain 7, Alistair Ring 8, Esther Herbert 6, Thompson G Robinson 9, Charlene Martin 1,2, Tim Chater 6, Kirsty Pemberton 6, Anne Shrestha 1,2, Anthony Nettleship 10, Paul Richards 5, Alan Brennan 5, Kwok Leung Cheung 11, Annaliza Todd 1,2, Helena Harder 3, Riccardo Audisio 12, Nicolo Matteo Luca Battisti 8, Juliet Wright 3, Richard Simcock 3, Christopher Murray 10, Alastair M Thompson 13, Margot Gosney 14, Matthew Hatton 15, Fiona Armitage 15, Julietta Patnick 16, Tracy Green 17, Deirdre Revill 17, Jacqui Gath 17, Kieran Horgan 18, Chris Holcombe 19, Matt Winter 15, Jay Naik 20, Rishi Parmeshwar 21

1 Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
2 Jasmine Breast Centre, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
3 Brighton and Sussex Medical School, Brighton, UK
4 Faculty of Health and Wellbeing, Department of Allied Health Professions, Collegiate Cresent Campus, Sheffield Hallam University, Sheffield, UK
5 Department of Health and Social Care Economics and Decision Science, School for Health and Related Research, University of Sheffield, Sheffield, UK
6 Clinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK
7 Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
8 Breast Unit, Royal Marsden Hospital, London, UK
9 Department of Cardiovascular Sciences, University of Leicester, Cardiovascular Research Centre, Glenfield General Hospital, Leicester, UK
10 EpiGenesys, University of Sheffield, Sheffield, UK
11 Breast Unit, Royal Derby Hospital, Derby, UK
12 Sahlgrenska Universitetssjukhuset, University of Gothenburg, Göteborg, Sweden
13 Department of Surgery, Baylor College of Medicine, Houston, TX, USA
14 School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
15 Breast Unit, Weston Park Hospital, Sheffield, UK
16 Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
17 Yorkshire and Humber Research Network Consumer Research Panel, Sheffield, UK
18 Breast Unit, Leeds General Infirmary, Leeds, UK
19 Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
20 Breast Unit, Pinderfields Hospital, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
21 Breast Unit, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, UK
* Corresponding author Email:

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