Management of operable breast cancer in older women

TY - JOUR

T1 - Management of operable breast cancer in older women

AU - Fentiman, Ian S.

PY - 2013/1

Y1 - 2013/1

N2 - Older women are not being given the opportunity to benefit from the improvements in both local and systemic treatment for breast cancer. Mamnnographic screening call/recall system ceases at age 72, making access more difficult. Knowledge about breast cancer in those aged >75 is significantly reduced in terms of understanding symptoms and personal risk but studies have shown that intervention can improve this, at least in the short term. Although older women are more likely to have estrogen receptor positive tumours, nevertheless, more than one-third of women aged over 70 have grade Ill, aggressive breast cancers. Whenever possible, older women should be offered breast conserving therapy rather than mastectomy since this not only improves their quality of life but also reduces risk of subsequent mental health problems. Endocrine treatment alone should not be used other than in patients with severe co-morbidity and a life-expectancy of less than a year. As adjuvant treatment in those with estrogen receptor positive cancers, the choice between tamoxifen and an aromatase inhibitor will depend upon co-morbidity, side-effects and patient choice.

AB - Older women are not being given the opportunity to benefit from the improvements in both local and systemic treatment for breast cancer. Mamnnographic screening call/recall system ceases at age 72, making access more difficult. Knowledge about breast cancer in those aged >75 is significantly reduced in terms of understanding symptoms and personal risk but studies have shown that intervention can improve this, at least in the short term. Although older women are more likely to have estrogen receptor positive tumours, nevertheless, more than one-third of women aged over 70 have grade Ill, aggressive breast cancers. Whenever possible, older women should be offered breast conserving therapy rather than mastectomy since this not only improves their quality of life but also reduces risk of subsequent mental health problems. Endocrine treatment alone should not be used other than in patients with severe co-morbidity and a life-expectancy of less than a year. As adjuvant treatment in those with estrogen receptor positive cancers, the choice between tamoxifen and an aromatase inhibitor will depend upon co-morbidity, side-effects and patient choice.

KW - RANDOMIZED CLINICAL-TRIAL

KW - MODIFIED RADICAL-MASTECTOMY

KW - PLUS TAMOXIFEN

KW - FOLLOW-UP

KW - AWARENESS

KW - SURGERY

KW - THERAPY

KW - RISK

KW - AGE

U2 - 10.1258/jrsm.2012.120183

DO - 10.1258/jrsm.2012.120183

M3 - Literature review

SN - 0141-0768

VL - 106

SP - 13

EP - 18

JO - Journal of the Royal Society of Medicine

JF - Journal of the Royal Society of Medicine

IS - 1

ER -