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Breast Cancer Treatment in Elderly Patients

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Abstract

Treating breast cancer in the older patient is very complex. Each patient must be evaluated on an individual basis as to their functional reserve, comorbidities, personal wishes, and estimated life expectancy. Further studies are warranted on this rapidly rising population.

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References

  1. Howlader N, Noone A, Krapcho M, et al. SEER Cancer Statistics Review, 1975–2012, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2012/, based on November 2014 SEER data submission, posted to the SEER web site, April 2015. Http://SeerCancerGov/Csr/1975_2012/. 2015:1–101. http://seer.cancer.gov/csr/1975_2012/sections.html.

  2. Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics Review, 1975–2013, National Cancer Institute. Bethesda, MD, http://seer.Cancer.Gov/csr/1975_2013/, based on November 2015 SEER data submission, posted to the SEER web site, Apr 2016.

  3. U. S. Census Bureau. An Aging Nation: The Older Population in the United States Retrieved November 5, 2016, from https://www.census.gov/prod/2014pubs/p25-1140.pdf. 2014.

  4. Murphy SL, Xu JQ, Kochanek KD. Deaths: final data for 2010. National vital statistics reports; vol 61 no 4. Hyattsville: National Center for Health Statistics; 2013.

    Google Scholar 

  5. Hutchins LF, Unger JM, Crowley JJ, Coltman CA, Albain KS. Underrepresentation of patients 65 years of age or older in cancer-treatment trials. N Engl J Med. 1999;341(27):2061–7. doi:10.1056/NEJM199912303412706.

    Article  CAS  PubMed  Google Scholar 

  6. Wyld L, Garg DK, Kumar ID, Brown H, Reed MWR. Stage and treatment variation with age in postmenopausal women with breast cancer: compliance with guidelines. Br J Cancer. 2004;90(8):1486–91. doi:10.1038/sj.bjc.6601742.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Diab SG, Elledge RM, Clark GM. Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst. 2000;92(7):550–6. http://www.ncbi.nlm.nih.gov/pubmed/10749910%5Cn; http://jnci.oxfordjournals.org/content/92/7/550.full.pdf

  8. Pierga JY, Girre V, Laurence V, et al. Characteristics and outcome of 1755 operable breast cancers in women over 70 years of age. Breast. 2004;13(5):369–75. doi:10.1016/j.breast.2004.04.012.

    Google Scholar 

  9. Bouchardy C, Rapiti E, Blagojevic S, Vlastos AT, Vlastos G. Older female cancer patients: importance, causes, and consequences of undertreatment. J Clin Oncol. 2007;25(14):1858–69. doi:10.1200/JCO.2006.10.4208.

    Article  PubMed  Google Scholar 

  10. Velanovich V, Gabel M, Walker EM, et al. Causes for the undertreatment of elderly breast cancer patients: tailoring treatments to individual patients. J Am Coll Surg. 2002;194(1):8–13. doi:10.1016/S1072-7515(01)01132-2.

    Article  PubMed  Google Scholar 

  11. Howlander N, Noone A, Krapcho M, Garshell J, Miller D, Altekruse S, et al. SEER cancer statistics review, 1975–2012. Bethesda: National Cancer Institute; 2015.

    Google Scholar 

  12. Gøtzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2011;1:CD001877. doi:10.1002/14651858.CD001877.pub4.

    Article  Google Scholar 

  13. Jonsson H, Bordás P, Wallin H, Nyström L, Lenner P. Service screening with mammography in northern Sweden: effects on breast cancer mortality – an update. J Med Screen. 2007;14(2):87–93. doi:10.1258/096914107781261918.

    Article  PubMed  Google Scholar 

  14. Roder D, Houssami N, Farshid G, et al. Population screening and intensity of screening are associated with reduced breast cancer mortality: evidence of efficacy of mammography screening in Australia. Breast Cancer Res Treat. 2008;108(3):409–16. doi:10.1007/s10549-007-9609-5.

    Article  CAS  PubMed  Google Scholar 

  15. Braithwaite D, Zhu W, Hubbard RA, et al. Screening outcomes in older US women undergoing multiple mammograms in community practice: does interval, age, or comorbidity score affect tumor characteristics or false positive rates? J Natl Cancer Inst. 2013;105(5):334–41. doi:10.1093/jnci/djs645.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Tan A, Kuo YF, Goodwin JS. Potential overuse of screening mammography and its association with access to primary care. Med Care. 2014;52(6):490–5. doi:10.1097/MLR.0000000000000115.

    Google Scholar 

  17. Sima CS, Panageas KS, Schrag D. Cancer screening among patients with advanced cancer. JAMA. 2010;304(14):1584–91. doi:10.1001/jama.2010.1449.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Bergman L, Kluck HM, van Leeuwen FE, et al. The influence of age on treatment choice and survival of elderly breast cancer patients in south-eastern Netherlands: a population-based study. Eur J Cancer. 1992;28(8–9):1475–80. doi:10.1016/0959-8049(92)90547-F.

    Article  Google Scholar 

  19. Mogal HD, Clark C, Dodson R, Fino NF, Howard-McNatt M. Outcomes after mastectomy and lumpectomy in elderly patients with early-stage breast cancer. Ann Surg Oncol. 2017;4(1):100–107. doi:10.1245/s10434–016–5582-8.

    Google Scholar 

  20. Chung A, Gangi A, Amersi F, et al. Not performing a sentinel node biopsy for older patients with early-stage invasive breast cancer. JAMA Surg. 2015;150(7):683–4.

    Article  PubMed  Google Scholar 

  21. Hughes KS, Schnaper LA, Bellon JR, et al. Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343. J Clin Oncol. 2013;31(19):2382–7. doi:10.1200/JCO.2012.45.2615.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Kunkler IH, Williams LJ, Jack WJL, Cameron DA, Dixon JM. Articles breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): a randomised controlled trial. Lancet Oncol. 2015;16:266–73. doi:10.1016/S1470-2045(14)71221-5.

    Article  PubMed  Google Scholar 

  23. Soulos PR, Yu JB, Roberts KB, et al. Assessing the impact of a cooperative group trial on breast cancer care in the medicare population. J Clin Oncol. 2012;30(14):1601–7. doi:10.1200/JCO.2011.39.4890.

    Article  PubMed  PubMed Central  Google Scholar 

  24. McCormick B, Ottesen RA, Hughes ME, et al. Impact of guideline changes on use or omission of radiation in the elderly with early breast cancer: practice patterns at national comprehensive cancer network institutions. J Am Coll Surg. 2014;219(4):796–802. doi:10.1016/j.jamcollsurg.2014.05.013.

    Article  PubMed  Google Scholar 

  25. Muss HB, Woolf S, Berry D, et al. Adjuvant chemotherapy in older and younger women with lymph node-positive breast cancer. JAMA. 2005;293:1073–81.

    Article  CAS  PubMed  Google Scholar 

  26. Giordano SH, Duan Z, Kuo YF, et al. Use and outcomes of adjuvant chemotherapy in older women with breast cancer. J Clin Oncol. 2006;24:2750–6.

    Article  PubMed  Google Scholar 

  27. Elkin EB, Hurria A, Mitra N, et al. Adjuvant chemotherapy and survival in older women with hormone receptor-negative breast cancer: assessing outcome in a population-based, observational cohort. J Clin Oncol. 2006;24:2757–64.

    Article  PubMed  Google Scholar 

  28. Piccart-Gebhart MJ, Procter M, Leyland-Jones B, et al. Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med. 2005;353:1659–72.

    Google Scholar 

  29. Smith I, Procter M, Gelber RD, et al. 2-year follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer: a randomised controlled trial. Lancet. 2007;369:29–36.

    Article  CAS  PubMed  Google Scholar 

  30. Tan-Chiu E, Yothers G, Romond E, et al. Assessment of cardiac dysfunction in a randomized trial comparing doxorubicin and cyclophosphamide followed by paclitaxel, with or without trastuzumab as adjuvant therapy in node-positive, human epidermal growth factor receptor 2-overexpressing breast cancer: NSABP B-31. J Clin Oncol. 2005;23:7811–9.

    Article  CAS  PubMed  Google Scholar 

  31. Carlson RW, Moench S, Hurria A, et al. NCCN task force report: breast cancer in the older woman. J Natl Compr Cancer Netw. 2008;6:S1–S25.

    Article  Google Scholar 

  32. Karuturi M, VanderWalde N, Muss H. Approach and management of breast cancer in the elderly. Clin Geriatr Med. 2016;32(1):133–53.

    Article  PubMed  Google Scholar 

  33. Dowsett M, Cuzick J, Ingle J, et al. Meta-analysis of breast cancer outcomes in adjuvant trials of aromatase inhibitors versus tamoxifen. J Clin Oncol. 2010;28:509–18.

    Article  CAS  PubMed  Google Scholar 

  34. Howell PA. Results of the ATAC (Arimidex, tamoxifen, alone or in combination) trial after completion of 5 years’ adjuvant treatment for breast cancer. Lancet. 2005;365(9453):60–2. doi:10.1016/S0140-6736(04)17666-6.

    Article  CAS  PubMed  Google Scholar 

  35. Robertson JF, Ellis IO, Elston CW, Blamey RW. Mastectomy or tamoxifen as initial therapy for operable breast cancer in elderly patients: 5-year follow-up. Eur J Cancer. 1992;28A(4–5):908–10.

    Article  CAS  PubMed  Google Scholar 

  36. Gazet JC, Ford HT, Coombes RC, et al. Prospective randomized trial of tamoxifen vs surgery in elderly patients with breast cancer. Eur J Surg Oncol.1994;20(3):207–14.

    Google Scholar 

  37. Fentiman IS, Christiaens MR, Paridaens R, et al. Treatment of operable breast cancer in the elderly: a randomised clinical trial EORTC 10851 comparing tamoxifen alone with modified radical mastectomy. Eur J Cancer. 2003;39(3):309–16. doi:10.1016/S0959-8049(02)00673-1.

    Article  CAS  PubMed  Google Scholar 

  38. 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. doi:10.1002/bjs.4603.

    Article  CAS  PubMed  Google Scholar 

  39. U.S. Preventive Services Task Force. Final update summary: breast cancer: screening. Sept 2016. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening1.

  40. Oeffinger KC, Fontham ET, Etzioni R, et al. Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA. 2015;314(15):1599–614. doi:10.1001/jama.2015.12783.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Lee CH, Dershaw DD, Kopans D, et al. Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other Technologies for the Detection of clinically occult breast cancer. J Am Coll Radiol. 2010;7(1):18–27. doi:10.1016/j.jacr.2009.09.022.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Wake Forest Baptist Health, Medical Center Boulevard, Winston-Salem, NC, 27157, USA

    Akiko Chiba MD

  2. Department of Surgery, Wake Forest Baptist Health, Medical Center Boulevard, Winston-Salem, NC, 27157, USA

    Marissa Howard-McNatt MD (Associate Professor of Surgery)

Authors
  1. Akiko Chiba MD
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  2. Marissa Howard-McNatt MD
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Corresponding author

Correspondence to Akiko Chiba MD .

Editor information

Editors and Affiliations

  1. Associate Professor of Surgery, Director Breast Care Center, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Marissa Howard-McNatt

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Chiba, A., Howard-McNatt, M. (2018). Breast Cancer Treatment in Elderly Patients. In: Howard-McNatt, M. (eds) Changing Paradigms in the Management of Breast Cancer . Springer, Cham. https://doi.org/10.1007/978-3-319-60336-0_13

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  • DOI: https://doi.org/10.1007/978-3-319-60336-0_13

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  • Publisher Name: Springer, Cham

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