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Primary breast cancer in the elderly
1Henrietta Banting Breast Centre, Women's College Hospital, Toronto, Ont.
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|October 23, 1997
Summary
This study redefines "old" for elderly breast cancer patients, emphasizing physiologic age and quality of life. A new treatment approach is proposed, considering functional status and cost-effectiveness for older women.
Area of Science:
- Geriatric Oncology
- Breast Cancer Research
- Clinical Decision-Making
Background:
- Breast cancer incidence rises with age, yet older women are underrepresented in clinical trials.
- Defining
- elderly
- by physiologic status rather than chronologic age is crucial for effective treatment.
Purpose of the Study:
- To define
- old
- in the context of breast cancer care for the elderly.
- To discuss factors influencing screening, diagnosis, and treatment decisions.
- To propose a treatment approach prioritizing quality of life, outcomes, and cost-effectiveness.
Main Methods:
- Literature review of breast cancer studies from 1980-1996 using MEDLINE.
- Inclusion of relevant studies from The Henrietta Banting Breast Centre Research Programme.
Main Results:
- Elderly women experience delayed diagnosis; screening compliance decreases with age.
- Treatment decisions often exclude women over 65; life expectancy is underestimated.
- Breast-conserving surgery is feasible; tamoxifen is a common adjuvant therapy.
Conclusions:
- A tailored treatment strategy for elderly breast cancer patients, considering functional status and quality of life, is essential.
- Future clinical trials must actively include and specifically design studies for older women.