Medical Oncology Department, Nuovo Ospedale-Santo Stefano Instituto Toscano Tumori, Prato 59100, Italy.
School of Medicine, University of Nottingham, United Kingdom.
J Geriatr Oncol. 2017 Nov;8(6):397-402. doi: 10.1016/j.jgo.2017.05.004. Epub 2017 Jun 9.
It is well recognized that the incidence of breast cancer increases significantly with age. Despite this, older people remain under-represented in many clinical trials and their management relies on extrapolation of data from younger patients. Providing an aggressive intervention can be challenging, particularly in less fit older patients where a conservative approach is commonly perceived to be more appropriate. The optimal management of this population is unknown and treatment decision should be personalized. This review article will discuss several controversial issues in managing older adults with early breast cancer in a multidisciplinary setting, including the role of surgical treatment of the axilla in clinically node negative disease, radiotherapy after breast conservation surgery in low-risk tumours, personalizing adjuvant systemic therapy, and geriatric assessments in breast cancer treatment decisions.
众所周知，乳腺癌的发病率随年龄增长显著增加。尽管如此，老年人在许多临床试验中的代表性仍然不足，他们的治疗依赖于从年轻患者中推断的数据。提供积极的干预措施可能具有挑战性，特别是在身体状况较差的老年患者中，通常认为保守方法更为合适。这一人群的最佳管理方法尚不清楚，治疗决策应因人而异。本文综述了多学科环境下治疗老年早期乳腺癌的几个有争议的问题，包括临床阴性淋巴结疾病中腋窝手术治疗的作用、低危肿瘤保乳手术后放疗、辅助全身治疗的个体化以及乳腺癌治疗决策中的老年评估。
