Breast Cancer in Women Older Than 80 Years

Abstract

Breast cancer is the most common cancer in women, with an incidence that rises dramatically with age. The average age at diagnosis of breast cancer is 61 years, and the majority of woman who die of breast cancer are age 65 years and older. Major improvements in public health and medical care have resulted in dramatic increases in longevity. The oldest old (those age 80 years and older) are a rapidly expanding group and now comprise 9 million members of the US population. The treatment of individuals who are age 80 years and older is complex and involves clearly defining the goals and value of treatment while also weighing risks, such as the potential effects of treatment on functional loss and quality of life. Limited evidence-based treatment guidelines exist for the caring of this older cohort of patients with breast cancer. Data from clinical trials that enroll primarily younger patients lack the information needed to estimate the likelihood of toxicities that can be life changing in older adults. Clinicians who make treatment recommendations should place the available evidence in the context of the patient's life expectancy and geriatric assessment results that include an evaluation of a patient's functional status, comorbidities, cognition, social support, nutritional status, and psychological state. Furthermore, these decisions should be placed in the context of the patient's goals for treatment, preferences, and values. This review summarizes the current literature and focuses on the role of geriatric assessment in treatment recommendations for patients age 80 years and older with early and metastatic breast cancer.

Treatment of Breast Cancer in Women Older Than 80 Years Is a Complex Task

“…1 The prevalence of breast cancer in older women is expected to rise even more dramatically than the incidence, thanks to improvement in survival. 1 The prevalence of breast cancer in older women is expected to rise even more dramatically than the incidence, thanks to improvement in survival.…”

Breast cancer treatment in women over the age of 80: A tailored approach

“…Although there are no studies in women 80 years and older, a study in women over 70 showed that omission of axillary staging did not affect overall or breast cancer specific mortality [12]. Patients with clinically involved axillary nodes should be considered for axillary dissection to control disease [13].…”

Specific Aspects of Breast Cancer Therapy of Elderly Women

“…The screening definitely has benefits such as reducing breast cancer mortality. Some studies, however, stated that the benefit is minimal against a nonnegligible overdiagnosis, which presents a source of anxiety for women [13]. The choice between the benefits and harms of screening should be shared with women who agreed to be screened.…”