Washington University in St. Louis School of Medicine, St. Louis, MO, United States.
Washington University in St. Louis School of Medicine, St. Louis, MO, United States.
Adv Cancer Res. 2020;146:23-56. doi: 10.1016/bs.acr.2020.01.003. Epub 2020 Feb 29.
Improvements in breast cancer (BC) mortality rates have not been seen in the older adult community, and the fact that older adults are more likely to die from their cancer than younger women establishes a major health disparity. Studies have identified that despite typically presenting with more favorable histology, older women present with more advanced disease, which may be related in part to delayed diagnosis. This is supported by examination of screening practices in older adults. Older women have a worse prognosis than younger women in both early stage disease, and more advanced and metastatic disease. Focus on the treatment of older adults has often concentrated on avoiding overtreatment, but in fact undertreatment may be one reason for the age-related differences in outcomes, and treatments need to be individualized for every older adult, and take into account patient preferences and functional status and not chronologic age alone. Given the aging population in the US, identifying methods to improve early diagnosis in this population and identify additional factors will be important to reducing this age-related disparity.
乳腺癌（BC）死亡率在老年人群中并未得到改善，而且老年人死于癌症的可能性比年轻女性更高，这就造成了一个重大的健康差距。研究表明，尽管老年女性的组织学表现通常更有利，但她们的疾病表现更为晚期，这可能部分与诊断延迟有关。这一点可以通过对老年人群筛查实践的研究来证实。在早期疾病、更晚期和转移性疾病中，老年女性的预后比年轻女性更差。对老年患者的治疗重点通常集中在避免过度治疗上，但事实上，治疗不足可能是导致年龄相关结局差异的一个原因，并且需要为每个老年患者制定个体化的治疗方案，同时考虑到患者的偏好、功能状态，而不仅仅是年龄。鉴于美国人口老龄化，确定改善该人群早期诊断的方法并确定其他因素对于缩小这一年龄相关差距将非常重要。
