Clinical management update: evaluation and management of older patients with breast cancer

Recent gains in life expectancy, coupled with aging as a risk factor for breast cancer, make breast cancer primarily a disease of older women. Evaluation of the biology of breast cancer according to age has suggested that estrogen receptor-positive, low-S-phase, low-tumor-grade, and human epidermal growth factor receptor 2-negative tumors are more common in older than younger women. However, this has not translated into any major survival advantage for older women with breast cancer over their younger counterparts. Several reasons, including undertreatment and underrepresentation in clinical trials, may account for this age-related disparity. In this brief review, recent practice-changing breast cancer updates of relevance to the care of older patients with breast cancer are discussed and summarized. Because the population is aging and the number of older patients with breast cancer will continue to increase, it is imperative that older patients with breast cancer be encouraged to participate in cutting edge research and that state-of-the-art oncology care be provided to this underserved population.