Bellet M, Alonso C, Ojeda B
Department of Medical Oncology, Hospital Sta Creu i Sant Pau, Barcelona, Spain.
Postgrad Med J. 1995 Nov;71(841):658-64. doi: 10.1136/pgmj.71.841.658.
Breast cancer in the elderly has attracted considerable interest in recent years for three main reasons. Firstly, information concerning the profile (clinical and biological) of the disease in the geriatric population is scarce; secondly, the number of patients is increasing, and thirdly there are conflicting data regarding the actual effectiveness of the different treatments. The present review attempts to outline the specific characteristics of this malignancy in the elderly in terms of histological pattern, stage at diagnosis, and outcome. The feasibility of standard therapies (mastectomy/lumpectomy, axillary clearance, and radio-therapy) in the elderly is carefully analysed, and compared to the efficacy of less aggressive procedures. The use of tamoxifen as a primary treatment, instead of surgery, is critically reconsidered, as well as its use as an adjuvant therapy. Finally, the effectiveness of systemic therapy in advanced disease is also discussed.
近年来，老年乳腺癌因三个主要原因而备受关注。首先，关于老年人群中该疾病特征（临床和生物学方面）的信息匮乏；其次，患者数量在增加；第三，关于不同治疗方法的实际疗效存在相互矛盾的数据。本综述试图从组织学模式、诊断分期和预后等方面概述老年患者这种恶性肿瘤的具体特征。仔细分析了标准疗法（乳房切除术/肿块切除术、腋窝清扫术和放射治疗）在老年患者中的可行性，并与侵入性较小的手术疗效进行比较。批判性地重新审视了使用他莫昔芬作为主要治疗方法而非手术治疗，以及其作为辅助治疗的使用情况。最后，还讨论了晚期疾病全身治疗的有效性。
