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J Geriatr Oncol. 2017 Nov;8(6):397-402. doi: 10.1016/j.jgo.2017.05.004. Epub 2017 Jun 9.

Controversial issues in the management of older adults with early breast cancer.

Author information

1
Medical Oncology Department, Nuovo Ospedale-Santo Stefano Instituto Toscano Tumori, Prato 59100, Italy.
2
School of Medicine, University of Nottingham, United Kingdom.
3
Department of Geriatric Medicine, Diakonessenhuis Utrecht/Zeist, The Netherlands.
4
Edinburgh Cancer Research Centre, Western General Hospital, University of Edinburgh EH4 2XU, Scotland, United Kingdom.
5
Medical School - Department of Surgery, National and Kapodistrian University of Athens, 11527 Athens, Greece.
6
European Institute of Oncology & University of Milan, Milan, Italy.
7
Department of Medical Oncology, Institut Curie/Hôpital René Huguenin, Saint-Cloud, France.
8
Medical Oncology Department, Nuovo Ospedale-Santo Stefano Instituto Toscano Tumori, Prato 59100, Italy. Electronic address: laura.biganzoli@uslcentro.toscana.it.

Abstract

It is well recognized that the incidence of breast cancer increases significantly with age. Despite this, older people remain under-represented in many clinical trials and their management relies on extrapolation of data from younger patients. Providing an aggressive intervention can be challenging, particularly in less fit older patients where a conservative approach is commonly perceived to be more appropriate. The optimal management of this population is unknown and treatment decision should be personalized. This review article will discuss several controversial issues in managing older adults with early breast cancer in a multidisciplinary setting, including the role of surgical treatment of the axilla in clinically node negative disease, radiotherapy after breast conservation surgery in low-risk tumours, personalizing adjuvant systemic therapy, and geriatric assessments in breast cancer treatment decisions.

KEYWORDS:

Chemotherapy; Early breast cancer; Geriatric assessment; Older adults; Radiotherapy; Surgery

PMID:
28602710
DOI:
10.1016/j.jgo.2017.05.004
[Indexed for MEDLINE]

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