Breast cancer in the elderly

Abstract

Breast cancer is the most commonly diagnosed cancer in women and most breast cancers are not attributable to risk factors other than female gender and increased age. However, despite its increasing prevalence in the geriatric population, prospective clinical trials for older cancer patients do not exist and most data come from retrospective studies or subanalyses from general population studies. As a result physician's, patient's and family members' fear predominates and elderly patients do not receive the appropriate treatment when compared with younger ones. Treatment is offered according to biological age alone and life expectancy, comorbidity and functional status are not considered when deciding treatment strategy. Surgery is often denied to patients older than 70 years of age, radiotherapy and chemotherapy are omitted due to the fear of toxicity and hormonal therapy, even though it represents a great tool as adjuvant therapy, it is associated with significant morbidity when chosen as primary treatment. Palliation of symptoms remains the main goal for metastatic disease but for the rest of the patients improving disease-free survival in the early stages should guide therapy no matter chronological age.