The study aim was to compare breast cancer treatment and survival between older and younger women treated at the University of Texas M. D. Anderson Cancer Center over a 30-year period, 1958-1987. Data were obtained from the Medical Informatics Tumor Registry and were examined by 15-year time periods. Treatments were stratified by no surgery, surgery alone, or surgery and additional treatment. Mantel-Haenszel chi-square statistics and actuarial life tables were used for comparisons. Among 3,382 women treated for breast cancer, treatment differed by age groups (p < 0.01). The most consistent finding by disease stage was that older women were less likely to receive treatment in addition to surgery compared to younger women (p < 0.01-0.05). Among women with local or regional involvement who received surgery and additional treatment, 5-year survival was similar regardless of age group. However, among women with distant disease who received surgery and additional treatment, 5-year survival differed significantly by age group (p = 0.03); women in the 65- to 74-year age group experienced the best survival. In this hospital population, older women with breast cancer who received surgery and additional treatment experienced similar, sometimes better, 5-year survival compared with younger women, which suggests that older women, in some cases, may benefit from combined modality treatment for breast cancer.