Gentile A, Greco L, Chiumarulo C
Dipartimento d'Odontoiatria e Chirurgia, Sezione di Chirurgia Generale, Università degli Studi di Bari.
Ann Ital Chir. 2003 May-Jun;74(3):275-8.
The incidence of breast carcinoma increases with advancing age. In view of the progressive aging of the population, this problem will tend to become more and more frequent. At present, patients of advanced age are often "undertreated" owing to the mistaken prejudice that older patients are unable to withstand standard multimodal therapy for this disease. In fact, there is no scientific evidence to that effect. Treatment choices should therefore be largely comparable to those adopted in younger patients. Even chemotherapy, which encounters the strongest resistance, by patients but also by doctors, should be administered when indicated. A number of studies have demonstrated that the toxic and side effects observed in elderly patients are comparable to those observed in younger age groups. In practice, particular attention needs to be paid when administering cytostatic treatment to patients over 80 years of age. Very conservative treatment (tamoxifen plus radiotherapy) may be reserved only to particularly frail elderly patients. In conclusion, the therapeutic choice should depend more on assessment of the biological age, life expectancy and patient's expectations than on the anagraphic age.
乳腺癌的发病率随年龄增长而增加。鉴于人口的逐渐老龄化，这个问题将趋于变得越来越常见。目前，高龄患者常常“治疗不足”，这是由于存在一种错误的偏见，即老年患者无法承受针对这种疾病的标准多模式治疗。事实上，并无科学证据支持这一观点。因此，治疗选择在很大程度上应与年轻患者所采用的选择相当。即使是化疗，尽管患者和医生对此都有最强烈的抵触情绪，但在有指征时也应进行。一些研究表明，在老年患者中观察到的毒性和副作用与在较年轻年龄组中观察到的相当。在实践中，对80岁以上的患者进行细胞毒性治疗时需要格外注意。非常保守的治疗（他莫昔芬加放疗）可能仅适用于特别体弱的老年患者。总之，治疗选择应更多地取决于对生物学年龄、预期寿命和患者期望的评估，而不是实际年龄。
