Management of elderly patients with breast cancer: the time for surgery

The proportion of elderly women in the population is rising, and in tandem, the incidence of breast cancer rises with age. Because of health and tolerability concerns, as well as life expectancy, physicians may be reluctant to advise a standard treatment regimen for elderly patients with metastatic breast cancer. To elucidate this issue, we performed a literature review of clinical studies that included women with metastatic breast cancer who were over the age of 65. Our results show that although little clinical evidence exists, what is available suggests that standard treatment is tolerated and beneficial for patients meeting certain criteria. A geriatric assessment may identify specific patient groups (independent, dependent, or frail) and thereby guide treatment. Treatment recommendations for elderly patients with metastatic breast cancer are sparse, although first-line endocrine treatment, usually aromatase inhibitors or tamoxifen, is recommended for hormone-sensitive disease. In general, the evidence from clinical studies suggests that aromatase inhibitors are more effective than either tamoxifen or megestrol acetate as first- or second-line treatment in postmenopausal women with metastatic breast cancer. Ultimately, quality of life, treatment effects, and comorbidities are important aspects in this population and may guide treatment choice. To provide evidence-based treatment guidance, future clinical trials should include more patients over the age of 65 years.

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Management of elderly patients with breast cancer: the time for surgery

Abstract: Age may have been used too rigidly to decide local treatment for elderly patients with breast cancer. Comprehensive multidisciplinary assessment is needed to make informed decisions and to optimize management of elderly patients.

Cited by 9 publications

References 18 publications

Primary Endocrine Therapy

Primary Endocrine Therapy

Cancer in the Very Elderly and Management

Aromatase inhibitors in the treatment of elderly women with metastatic breast cancer

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