Outpatient Treatment of Clinically Node-negative Breast Cancer in Elderly Women

Successful management of elderly women with breast cancer presents a wide range of issues and challenges. The Istituto Nazionale per lo Studio e la Curo dei Tumori of Milan has performed a series of studies of women over age 70 years with clinically localized breast cancer which confirms the safety and effectiveness of wide local excision without lymph node dissection on an outpatient basis and under local anesthesia when axillary nodes are not palpable. Size and biologic characteristics such as hormone receptor status and proliferative activity have been used to determine the extent of effect of additional treatment with breast irradiation and tamoxifen on disease-free survival and actual survival. Factors affecting compliance to treatment protocols are being assessed.