Treatment of breast cancer in older women

Bernardi, Daniele; Errante, D.; Galligioni, Enzo; Crivellari, Diana; Bianco, Antonio; Salvagno, Luigi; Fentiman, Ian S.

doi:10.1080/02841860701630234

Cited by 38 publications

(41 citation statements)

References 108 publications

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“…The use of endocrine therapy as the only treatment of breast cancer has decreased at our center [5,15,19]. Nowadays, only 3% of our patients are treated in this way.…”

Section: Discussionmentioning

confidence: 99%

Primary Hormonal Therapy for Elderly Breast Cancer Patients: Single Institution Experience

Panal

Sánchez-Méndez

Revello

et al. 2014

Gynecol Obstet Invest

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Aims: Breast cancer is the most frequently diagnosed cancer among women. Up to 50% of breast cancer cases occur in patients over the age of 65 years. Hormonal therapy as a single alternative treatment has been used in this population. The aim of this study was to analyze the oncological outcomes in breast cancer patients who received hormonal therapy alone as a primary treatment. Methods: We retrospectively reviewed our database to find all patients with breast cancer from 2006 to 2011 who were treated with hormonal therapy only at our center. The collected data included patients and tumor characteristics, type of drug administered, follow-up details and type of response obtained using RECIST criteria. Results: We included 44 breast cancer patients. The mean age was 83.5 ± 6.0 years. The majority of patients had tumors with less aggressive immunohistochemical characteristics and 100% of them presented positive estrogen receptors. The pharmacological treatment included exemestane, anastrozole, tamoxifen, letrozole and fulvestrant. The effectiveness rate was 60%, evaluated according to tumor reduction or no progression. Conclusion: The efficacy of hormonal therapy in older patients is reasonably high to justify its use in selected patients. Therefore, it is a sensible alternative for patients who refuse or are unfit for surgery.

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“…The use of endocrine therapy as the only treatment of breast cancer has decreased at our center [5,15,19]. Nowadays, only 3% of our patients are treated in this way.…”

Section: Discussionmentioning

confidence: 99%

Primary Hormonal Therapy for Elderly Breast Cancer Patients: Single Institution Experience

Panal

Sánchez-Méndez

Revello

et al. 2014

Gynecol Obstet Invest

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“…The number of women aged 65 and above in Germany is expected to double in the next 20 years (NCCN) as the generation of baby boomers becomes older (in Germany, persons born between 1955 and 1965 are defined by statisticians as part of the baby-boom generation). This is important, because women over 70 are currently under-represented in the adjuvant clinical trials carried out to date, meaning that therapy decisions are often taken without being based on sufficient reliable data [4][5][6][7]. It is important to note that certain factors may also be significant in addition to purely chronological age.…”

Section: Zusammenfassungmentioning

confidence: 99%

“…It is important to note that certain factors may also be significant in addition to purely chronological age. Such factors include physiological and functional reserve, co-morbidities, cognitive function, the availability of social support and individual life expectancy [5,7]. For example, 17% of the group aged between 65 and 74 had 6 co-morbidities.…”

Section: Zusammenfassungmentioning

confidence: 99%

Chemotherapy for 70-Year-Old Women with Breast Cancer in Germany: A Survey by the German Breast Group

Barinoff

Traut

Bauerschlag

et al. 2013

Geburtsh Frauenheilk

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!Aim: Around half of all women in Germany with breast cancer are older than 65 and approximately one third of them is older than 70 years of age. In theory, the preferred therapeutic management of women with breast cancer aged 65 and above corresponds to that formulated for younger patients and complies with the S3 Guidelines and the therapy recommendations formulated by AGO. To study the current therapies used to treat women with breast cancer aged 70 and above in Germany, a survey of the clinics of the German Breast Group (GBG) was done. Method: An online survey was carried out with requests sent to 599 physicians registered as principal investigators in the database of the GBG. The 12-item questionnaire was used to investigate the systematic therapeutic management of 70-yearold patients in different settings. The indication for chemotherapy was taken as a given. Results: In a neoadjuvant setting, 62 % of physicians opted for anthracycline and taxane-based therapy as did 56.6 % of physicians in an adjuvant setting. One third of physicians preferred a taxane-based therapy with the anti-angiogenesis inhibitor bevacizumab as first-line therapy for primary metastatic cancer and after anthracyclinebased therapy. Capecitabine (around 30%) and navelbine (around 20%) were proposed as second-line neoadjuvant and adjuvant therapies after prior anthracycline-and taxane-based therapy. Conclusion: The chemotherapy regimen prescribed for women with breast cancer aged 70 and above in Germany appears to be relatively standardised and corresponds to the recommendations given in the S3 Guidelines and by the AGO Breast Committee. Zusammenfassung! Ziel: Ca. die Hälfte der Patientinnen mit Mammakarzinom ist über 65 Jahre alt und ca. ein Drittel ist älter als 70 Jahre. Formell entsprechen die therapeutischen Präferenzen für die über 65-jährigen Brustkrebspatientinnen den Konzepten für jün-gere Patientinnen und sind konform mit den Konzepten in der S3-Leitlinie sowie den von der AGO formulierten Therapieempfehlungen. Um das aktuelle Therapieverhalten in Deutschland für über 70-jährige Patientinnen mit Mammakarzinom zu erfassen, wurde eine Umfrage bei Prüfzentren der German Breast Group (GBG) durchgeführt. Methode: Es wurde eine Online-Umfrage unter 599 studienverantwortlichen Ärzten durchgeführt, die in der Datenbank der GBG als Prüf-arzt/ärztin registriert sind. Mit dem 12-Item-Fragebogen wurde die systemische Therapieeinsätze bei einer 70-jährigen Patientin in verschiedenen Settings untersucht. Die Indikation für eine Chemotherapie wurde als gegeben definiert. Ergebnis: 62 % der Ärzte in der Neoadjuvanz und 56,6 % in der Adjuvanz entschieden sich für eine anthrazyklin-und taxanhaltige Therapie. In der primär metastasierenden Situation sowohl in der First-Line-Therapie nach einer anthrazyklinhaltigen Therapie wurde von einem Drittel der Befragten eine taxanhaltige Therapie mit Antiangiogenese-Hemmer Bevacizumab präferiert. Bestand der Status nach anthrazyklin-und taxanhaltiger Therapie in der Neo-/Adjuvanz, so wurden solch...

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“…To the Editor, We thank Looij et al [1] for their comment on our review [2], dealing with local treatment for older patients affected by breast cancer.…”

Section: In Replymentioning

confidence: 99%