[Breast carcinoma in the elderly patient: which treatment?].

We here describe our experience of the treatment of "breast cancer" in the elderly. The results in this group of patients (37 over 75 years) are like the younger group if: the local control is done; hormonotherapy is prescribed; chemotherapy is done even in the 70-80-year-old group. If a radical mastectomy isn't impossible in the patients over 80, even a simple mastectomy is safe. In this patients a conservative local treatment of the breast is not mandatory. Our over-75-year-old patients have no psychological problem related to mastectomy. They often don't accept obligatory radiotherapy after the conservative treatment of breast cancer, and moreover the breast cancer in the elderly is usual smaller, fibrotic and bigger than 3 cm. Lymph nodal status isn't important for overall survival, but only for the eventual chemotherapeutic treatment, so in patients over 80 year-old simple mastectomy is sufficient because we don't use chemotherapy for the general conditions of the same. The local control of axillary lymph nodes is obtained with radiotherapy if necessary. Screening for breast cancer must also include 70-75-year-old patients. Why is the breast cancer in elderly like the others patients? Some authors have seen that the immuno-reaction around the cancer in elderly is less than the same reaction observed in younger patients. So in the elderly there is a smaller production of "growth factors" important for the growth of the tumor and of "angiogenesis factor", fundamental for the initial growth of the cancer.(ABSTRACT TRUNCATED AT 250 WORDS)