THE ROLE OF SURGICAL INTERVENTION IN THE MULTIMODAL TREATMENT OF BREAST CANCER IN OLDER WOMEN

Breast cancer is a leading cause of cancer morbidity and mortality among women, with an increasing proportion of older patients. This population exhibits significant heterogeneity in health status, complicating treatment decisions. Surgical intervention remains a cornerstone of multimodal therapy for localized disease. This narrative review aims to clarify its role in older patients by synthesizing and discussing key contemporary evidence from the literature (2015-2025). Findings indicate that chronological age alone is not a contraindication to surgery. With careful patient selection, including comprehensive geriatric assessment (CGA), surgical treatment can be performed safely with acceptable outcomes. For biologically favorable tumors, de-escalation strategies (e.g., breast-conserving surgery, limited axillary procedures) are viable. Conversely, unjustified omission of surgery in aggressive disease worsens survival. Thus, treatment must be individualized, integrating CGA, comorbidity burden, functional status, and tumor biology rather than relying on age.