Current Strategies of Endocrine Therapy in Elderly Patients with Breast Cancer

Abstract

Currently, the growing population of the elderly is one of biggest problems in terms of increase in geriatric diseases. Lack of data from large prospective studies on geriatric breast cancer patients often makes it difficult for clinicians to make treatments decisions for them. Because both benefit and risk of treatment should be taken into account, treatment is usually determined considering life expectancy or comorbidities in elderly patients. Treatment of breast cancer is differentiated according to histologic classifications, and hormone therapy is even adopted for patients with metastatic breast cancer if tumor tissue expresses hormone receptors. Endocrine therapy can offer great benefit to elderly patients considering its equivalent efficacy to chemotherapy with fewer toxicities if it is appropriately used. Aromatase inhibitors are usually prescribed agents in hormone therapy for elderly breast cancer patients due to their physiology after menopause. Here, endocrine therapy for elderly patients with breast cancer in neoadjuvant, adjuvant, and palliative setting is reviewed along with predictive adverse events resulting from the use of hormone agents.

Nomogram for Predicting Breast Cancer-Specific Mortality of Elderly Women with Breast Cancer

“…ER and PR positivity is more common in elderly patients than in younger patients [ 6 , 33 ], indicating that the elderly are more likely to be sensitive to endocrine therapy. Additionally, endocrine therapy offers great benefit to elderly patients considering its equivalent efficacy to chemotherapy with a low risk of toxicities if appropriately used [ 34 ]. Although the conventional treatment for breast cancer is surgical resection, several prospective clinical trials have indicated much better outcomes for older patients with small, HR-positive tumors who receive tamoxifen alone than surgery [ 35 ].…”

The G8 frailty screening tool and the decision‐making process in older breast cancer patients

“…Hospital visits are necessary to evaluate the effectiveness of endocrine therapy and for timely recognition of disease progression. All these aspects are associated with non-adherence (Holland et al, 2013;Lee & Seo, 2018) and might burden patient and their caregivers (Jayani & Hurria, 2012). Furthermore, knowing that there is a risk of tumour grow without surgical treatment, might lead to distress in some patients.…”

Combination of circulating miR-145-5p/miR-191-5p as biomarker for breast cancer detection

“…In this regard, mammography screening is confidently recommended for women over 50 years old, although women aged 40–50 years are also at risk of BC ( McDonald et al, 2016 ; Nelson et al, 2016 ; Phi et al, 2018 ). Various molecular subtypes of BC that require different therapy ( EBCTCG, 2015 ; Guerrero-Zotano & Arteaga, 2017 ; Lee & Seo, 2018 ), individual patient susceptibility to drugs and side effects from drugs ( Potosky et al, 2015 ; Greenlee et al, 2017 ; Moo et al, 2018 ) and the development of drug resistance ( Li et al, 2020 ; Zhong et al, 2020 ) make treatment of this disease more difficult and complicated. The listed difficulties indicate the need for study of new biomarkers that can help in the early detection, diagnosis and prognosis of BC.…”