When cancer in older adults is undermanaged: the breast cancer story.

Age is the most important risk factor for breast cancer; age is also a risk factor for undermanagement of breast cancer. One thousand eight hundred fifty-nine women aged 65 and older with early-stage breast cancer were studied, and it was found that undermanagement is a risk factor for recurrence and for dying of breast cancer. Although conservative treatment is probably warranted in patients with tumors having excellent prognostic characteristics and in women with limited life expectancies, standard treatment is needed for the majority of older women if the disproportionate burden of breast cancer in this age group is to be reduced. Better strategies are needed for identifying those most likely to benefit from standard treatment and from systematic surveillance for recurrence. In this regard, collaboration between oncologists and primary care physicians is essential for achieving high-quality care and outcomes in this vulnerable group of patients.