Wyld L, Reed M W R
Academic Surgical Oncology Unit, University of Sheffield, K Floor, Royal Hallamshire Hospital, Glossop Road, UK.
Br J Surg. 2003 Apr;90(4):388-99. doi: 10.1002/bjs.4124.
Breast cancer is a major source of morbidity and mortality in elderly women. Despite this, many trials on which clinical practice is based have under-represented the elderly. Consequently there is little evidence to guide best practice in this age group.
A search of the major literature databases was performed using the search terms 'breast cancer' and 'elderly'. Articles relevant to the treatment of breast cancer in the elderly were selected.
The elderly receive less aggressive treatment for breast cancer compared with younger patients. Primary endocrine therapy is sometimes substituted for operation, and axillary surgery, adjuvant chemotherapy and adjuvant radiotherapy are commonly omitted. Evidence for and against such treatment strategies is inadequate, making it difficult to determine what constitutes best practice.
There is a need for research to be targeted at the older age group of patients with breast cancer to enable the development of specific treatment guidelines.
乳腺癌是老年女性发病和死亡的主要原因。尽管如此,许多作为临床实践依据的试验中老年人的代表性不足。因此,几乎没有证据可指导该年龄组的最佳治疗实践。
使用搜索词“乳腺癌”和“老年人”对主要文献数据库进行检索。选取与老年乳腺癌治疗相关的文章。
与年轻患者相比,老年人接受的乳腺癌治疗不够积极。有时会用原发性内分泌治疗替代手术,腋窝手术、辅助化疗和辅助放疗通常被省略。支持和反对这种治疗策略的证据都不充分,难以确定什么是最佳治疗实践。
需要针对老年乳腺癌患者群体开展研究,以制定具体的治疗指南。