Breast cancer treatment in women over the age of 80: A tailored approach. (April 2018)

• Record Type: Journal Article
• Authors: Glaser, Rebecca; Marinopoulos, Spyridon; Dimitrakakis, Constantine
• Is Part Of: Maturitas. Volume 110(2018)
• Page Start: 29
• Page End: 32
• Publication Date: 2018-04
• Subjects: Octogenarian -- Age over 80 -- Breast cancer -- Screening -- Surgery -- Adjuvant therapy; Climacteric -- Periodicals; Menopause -- Periodicals; Climacteric -- Periodicals; Geriatrics -- Periodicals; Menopause -- Periodicals; Middle Aged -- Periodicals; Climatère -- Périodiques; Ménopause -- Périodiques; Climacterium; Climacteric; Menopause; Electronic journals; Periodicals; 612.66
• DOI: 10.1016/j.maturitas.2018.01.014
• Languages: English
• ISSNs: 0378-5122

Abstract

Highlights: 12% of all breast cancer cases occur in women over 80 years of age. Treatment plans for breast cancer in octogenarians should consider co-morbidities. Online tools can assess life expectancy and benefits and risks of cancer therapies. Surgical therapy is well tolerated in octogenarians and should not be underutilized. Axillary staging and radiation therapy may be omitted in some cases. Abstract: 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.