The management of elderly patients with brain metastases from breast cancer

Breast cancer is the most common type of malignancy diagnosed in women worldwide, as well as the second most common cause of metastatic brain lesions in the general population. Most breast cancer patients enrolled in clinical trials are relatively young. Elderly patients, as compared to their younger counterparts, pose unique clinical scenarios because there is limited data in this subpopulation of patients with brain metastases from breast cancer. Elderly patients are commonly treated with less aggressive therapies, perhaps due to comorbid conditions, patient preference, or other age-related concerns. Current treatment modalities offering more favorable toxicity profiles, along with more accurate prognosis, can represent an opportunity to offer improved care for this patient population. From the few efforts studying brain metastatic disease in the elderly, it is be possible to infer that age alone may not play an independent role in treatment selection and that a patient-specific evaluation and ultimate clinical judgment should guide clinical decision-making.