Tariq Parvez.
Breast Cancer Management in Old Age: A review.
J Coll Physicians Surg Pak Jan ;12(7):438-42.

Nearly half of cases of breast cancer occur after the age of 65 in USA. Early breast cancer may be influenced by patient age, including postoperative irradiation after partial mastectomy, axillary lymphadenectomy, primary medical treatment of early breast cancer, and adjuvant chemotherapy. In this reviewed article the literature regarding age-specific issues in the management of breast cancer in old age is discussed. In terms of survival and disease-free survival, tamoxifen alone in primary breast cancer is inferior to surgical treatment followed by adjuvant tamoxifen. Adjuvant chemotherapy is beneficial to women with hormone receptor-poor tumors. In those with hormone receptor-rich tumors, adjuvant chemotherapy is beneficial for HER2-positive tumors, and the regimen should contain an anthracycline. Although the risk of local recurrence after partial mastectomy declines with increasing age, the decision to omit radiation therapy is individualized based on risk of recurrence and on patient`s desire and available resources. The advent of lymph node mapping and sentinel node biopsy obviates the need for lymphadenectomy in most patients.The use of adjuvant chemotherapy should be individually assessed according to tumor stage, life expectancy, co-morbidity and expected tolerance of treatment and risks benefits ratio.

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