Presented by Lee S. Schwartzberg, MD, The University of Tennessee Health Science Center, West Cancer Center, Memphis, Tennessee, and Sarah L. Blair, MD, Department of Surgery, University of California San Diego Moores Cancer Center, La Jolla, California.
J Natl Compr Canc Netw. 2016 May;14(5 Suppl):647-50. doi: 10.6004/jnccn.2016.0182.
Older patients with breast cancer (aged ≥65 years) are often undertreated with both locoregional and systemic therapies and have been shown to have higher breast cancer-specific mortality. These patients are also excluded from most clinical trials; therefore, treatment recommendations are extrapolated from younger populations. The data that do exist, however, show that older patients usually tolerate and respond well to conventional treatments. When selecting treatments for breast cancer, age should not be the chief consideration; comorbidities and functional status are also important, as is life expectancy. For patients with an estimated survival of less than 5 years, aggressive treatment may be discouraged; however, if the estimated survival is 5 years or more, treatment according to recurrence risk is recommended. In the curative setting, undertreatment should be avoided.
老年乳腺癌患者（年龄≥65 岁）在局部和全身治疗方面往往治疗不足，并且乳腺癌特异性死亡率更高。这些患者也被排除在大多数临床试验之外；因此，治疗建议是从年轻人群中推断出来的。然而，现有的数据表明，老年患者通常能够耐受并对常规治疗有良好的反应。在选择乳腺癌治疗方法时，年龄不应是主要考虑因素；合并症和功能状态也很重要，预期寿命也是如此。对于预计生存时间少于 5 年的患者，可能不鼓励采用积极的治疗方法；但是，如果预计生存时间为 5 年或更长时间，则建议根据复发风险进行治疗。在治愈性治疗中，应避免治疗不足。
