Management of Operable Primary Breast Cancer in Older Women

Abstract

A considerable number of breast cancer diagnoses are made in older women. Differing physiological needs of older patients and biology of tumors compared with younger patients may alter treatment options between surgery and nonsurgical primary approaches. Adjuvant therapies may benefit these patients; however, concerns about toxicity and physical demands of treatment may affect patient choice regarding treatment. Furthermore, quality of life may be more important to the older individual than curative treatment alone. Growing evidence is emerging for employing Comprehensive Geriatric Assessment to determine other factors that may contribute to treatment decision-making in the older population. The way geriatric oncology is delivered varies, bringing the importance of the multidisciplinary team to the forefront of care delivery in this age group. Future research in this area should include combined consideration of tumor biology and geriatric needs.

Third Symposium on Primary Breast Cancer in Older Women

“…There was a significant difference in both the breast cancer specific and overall survival in favor of the younger group. These findings are similar to other studies [1][2][3][4][5]7].. w. were aged 70 and above, and 2432 patients (86%) were aged below 70. More elderly patients had mastectomy than breast conservation (p < 0.0005).…”

“…The most frequently reported motivations were a wish to survive or avoid recurrence and the clinician's recommendation; and motivations against therapy were side effects and the long treatment duration. Older patients frequently reported additional motivations against chemotherapy (e.g., maintaining quality of life and independence) [1][2][3][4][5][6]. …”

“…The management of breast cancer in the elderly population is currently under debate [1][2][3][4][5][6]. In particular there is concern that elderly patients receive suboptimal treatment [1][2][3][4][5][6].…”

“…In particular there is concern that elderly patients receive suboptimal treatment [1][2][3][4][5][6]. The aim of the study is to evaluate the characteristics, management and outcome of breast cancer in two demographic groups of patients aged 50-69 years and 70 years and above at diagnosis in a district general hospital.…”

Compliance with multidisciplinary team recommendations and disease outcomes in early breast cancer patients: An analysis of 4501 consecutive patients

“…The poor compliance of elderly patients observed here is consistent with previously published studies showing that MDT recommendations were more likely to be changed in elderly women [ 19 ]. Among patients aged 70–85 years, only 56.9% patients were reported to receive planned adjuvant chemotherapy after MDT discussions [ 12 ], which may be because older women may be frailer and less likely to tolerate conventional chemotherapy [ 20 ]. Moreover, clinicians were also unwilling to offer chemotherapy to older patients because of the small survival benefit in these patients [ 12 ].…”