Millennium Wellness Center, 228 E. Spring Valley Road, Dayton, Ohio 45458, USA; Wright State University Boonshoft School of Medicine, Department of Surgery, 3460 Colonel Glenn Highway, Dayton, Ohio 45435, USA.
1st Department of Ob-Gyn, Athens University Medical School, 80 Vas Sophias Street, 11528, Athens, Greece.
Maturitas. 2018 Apr;110:29-32. doi: 10.1016/j.maturitas.2018.01.014. Epub 2018 Jan 27.
Breast cancer treatment in women over the age of 80 remains a complex issue due to pre-existing comorbidities, therapy-related toxicities, and the lack of evidence-based data in this population, leading to both overtreatment and under treatment. The average life expectancy of an 80-year-old woman is 9.7 years and chronologic age alone should not be a factor in withholding therapy. Women over age 80 should be treated on an individual basis, taking into account their overall health and life expectancy, their risk of dying from breast cancer versus other causes, and the benefits versus toxicities of therapies for their tumor. Invaluable online tools are readily available to easily assess life expectancy (ePrognosis), as well as the absolute survival benefits for every tumor type and stage in individual patients (PREDICT, Ajuvant!). This information should be presented to the patient so that they are able to make an informed decision based on their goals, wishes and quality of life. Vulnerable patients should not be bullied or scared into taking unwanted or unnecessary treatments.
由于存在合并症、与治疗相关的毒性以及该人群缺乏基于证据的数据，80 岁以上女性的乳腺癌治疗仍然是一个复杂的问题，导致过度治疗和治疗不足。一位 80 岁女性的平均预期寿命为 9.7 年，单纯的年龄不应成为拒绝治疗的因素。80 岁以上的女性应根据个人情况进行治疗，考虑到她们的整体健康和预期寿命、死于乳腺癌与其他原因的风险，以及治疗肿瘤的益处与毒性。评估预期寿命（ePrognosis）以及每个患者的每种肿瘤类型和分期的绝对生存获益的宝贵在线工具（PREDICT、Ajuvant！）都易于获取。应向患者提供这些信息，以便他们能够根据自己的目标、愿望和生活质量做出明智的决策。不应欺负或恐吓脆弱的患者接受不想要或不必要的治疗。
