Bridging the age gap in breast cancer. Impacts of omission of breast cancer surgery in older women with oestrogen receptor positive early breast cancer. A risk stratified analysis of survival outcomes and quality of life

•Propensity matched study of women >70 with breast cancer comparing surgery or PET•Unmatched analysis found surgery improves overall & disease-specific survival.•Matched analysis (stage, age, health, frailty) found similar disease-specific survival•Surgery led to adverse events in 19% & negative impacts on QoL and physical function•Less fit women >85 may be offered PET to reduce morbidity, without survival detriment