Breast Cancer in Elderly Women

  • BBSG – Brazilian Breast Study Group


Elderly patients are more likely to receive incomplete treatment for breast cancer because they generally present with physical comorbidities that may limit cancer treatment. In addition, cancer in this group tends to be less aggressive and life expectancy is consequently lower.


Older patient Management Performance status Chemotherapy Axillary surgery 

Recommended Reading

  1. 1.
    Chesney TR, Yin JX, Rajaee N, Tricco AC, Fyles AW, Acuna SA, et al. Tamoxifen with radiotherapy compared with Tamoxifen alone in elderly women with early-stage breast cancer treated with breast conserving surgery: a systematic review and meta-analysis. Radiother Oncol. 2017;123(1):1–9. Meta-analysis of the main studies that evaluated the benefit of radiotherapy in patients over 70 years and initial tumors with positive hormone receptors treated with conservative surgery and tamoxifen. Radiotherapy reduced local recurrences (RR = 0.18 [95% CI: 0.10-0.34]), but did not change overall survival (RR = 0.98 [95% CI: 0.79-1.22]). CrossRefGoogle Scholar
  2. 2.
    Fennessy M, Bates T, MacRae K, Riley D, Houghton J, Baum M. Late follow-up of a randomized trial of surgery plus tamoxifen versus tamoxifen alone in women aged over 70 years with operable breast cancer. Br J Surg. 2004;91(6):699–704. A randomized clinical study in patients over 70 years of age with initial breast cancer and positive hormone receptors. The study compared surgery and tamoxifen with tamoxifen alone. After 10 years of follow-up, women who had surgery had a longer relapse-free survival time (HR = 4.41 [95% CI: 3.31-5.58]), overall survival (HR = 1.29 [95% CI: : 1.04-1.59]) and specific survival (HR = 1.68 [95% CI: 1.15-2.47]). CrossRefGoogle Scholar
  3. 3.
    Freedman RA, Keating NL, Partridge AH, Muss HB, Hurria A, Winer EP. Surveillance mammography in older patients with breast cancer-can we ever stop?: a review. JAMA Oncol. 2017;3(3):402–9. Review on breast cancer screening in women over 70 who have had the disease. The authors suggest biennial mammography for all women with life expectancy above 5 years, similar to that recommended for those without prior disease. CrossRefGoogle Scholar
  4. 4.
    Martelli G, Boracchi P, Orenti A, Lozza L, Maugeri I, Vetrella G, et al. Axillary dissection versus no axillary dissection in older T1N0 breast cancer patients: 15-year results of trial and out-trial patients. Eur J Surg Oncol. 2014;40(7):805–12. A randomized clinical study with 238 patients with T1 N0 tumors comparing the performance of axillary surgery or not. After 15 years of follow-up, overall survival was similar (37% vs. 33%) and axillary recurrences were acceptable (0% vs. 5%). CrossRefGoogle Scholar
  5. 5.
    Smith IE, Fribbens C. Management of breast cancer in older and frail patients. Breast. 2015;(Suppl 2):S159–62. Review on the treatment of breast cancer in women over 65 years, with emphasis on the possibilities of systemic therapy. CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • BBSG – Brazilian Breast Study Group
    • 1
  1. 1.BBSGSao PauloBrazil

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