PURPOSE

To present an approach to the treatment of primary and metastatic breast cancer in the elderly.

DESIGN

A large number of studies in elderly women with breast cancer have been reviewed.

RESULTS

The studies reviewed demonstrate that the annual incidence of breast cancer increases with age, along with a longer life expectancy. Biennial mammography and annual physical examination are effective, but compliance with screening recommendations decreases with age. Most treatment decisions are based on studies that seldom include women over 65 years of age. With the exception of specific comorbid conditions that preclude anesthesia and surgery, older women tolerate breast surgery as well as younger women. Tamoxifen is the usual adjuvant systemic therapy given to older women. Metastatic breast cancer older women, in generally good condition, tolerate standard doses of chemotherapy as well as their younger counterparts.

CONCLUSIONS

Future research should include clinical trials designed specifically for the elderly taking into account functional status and quality of life.