[Breast cancer irradiation in elderly]

Area of Science:

• Oncology
• Radiotherapy Research

Background:

• Breast cancer (BC) affects approximately 25% of women over 70 in Western countries.
• Locoregional relapse (LRR) is a critical factor for subsequent metastases, making local control essential for cure.
• Adjuvant radiotherapy (RT) plays a vital role in managing breast cancer, particularly in high-risk cases.

Purpose of the Study:

• To evaluate the efficacy of radiotherapy in reducing locoregional relapse in breast cancer patients.
• To assess the impact of RT on long-term survival rates across different treatment scenarios.
• To provide guidance on RT utilization in elderly breast cancer patients.

Main Methods:

• Analysis of multiple trials and meta-analyses on the role of radiotherapy after mastectomy and breast-conserving surgery.
• Comparison of RT efficacy with hormonal treatment for local control.
• Consideration of hypofractionated RT and partial breast irradiation techniques for elderly populations.

Main Results:

• RT reduces LRR rates by 60-70% after mastectomy and increases long-term survival by 8-9%.
• After breast-conserving surgery, RT decreases 10-year local recurrence rates from 20-25% to 5-8%.
• Replacing RT with hormonal treatment results in significantly higher LRR rates.

Conclusions:

• Adjuvant radiotherapy is highly effective in reducing LRR and improving survival for breast cancer patients, irrespective of age.
• Elderly women eligible for treatment should receive adjuvant RT according to guidelines to prevent undertreatment and ensure optimal outcomes.
• While hypofractionated RT and partial breast irradiation are being investigated for the elderly, standard RT remains crucial for local control and survival benefits.