Management of breast cancer in elderly individuals: recommendations of the International Society of Geriatric Oncology.
Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer mortality in women worldwide. Elderly individuals make up a large part of the breast cancer population, and there are important specific considerations for this population. The International Society of Geriatric Oncology created a task force to assess the available evidence on breast cancer in elderly individuals, and to provide evidence-based recommendations for the diagnosis and treatment of breast cancer in such individuals. A review of the published work was done with the results of a search on Medline for English-language articles published between 1990 and 2007 and of abstracts from key international conferences. Recommendations are given on the topics of screening, surgery, radiotherapy, (neo)adjuvant hormone treatment and chemotherapy, and metastatic disease. Since large randomised trials in elderly patients with breast cancer are scarce, there is little level I evidence for the treatment of such patients. The available evidence was reviewed and synthesised to provide consensus recommendations regarding the care of breast cancer in older adults.
Department of General Medical Oncology, University Hospital Gasthuisberg, Leuven, Belgium. Electronic address: hans.wildiers@uzleuven.be.
Hans
H
Wildiers
Edinburgh Cancer Centre, University of Edinburgh, Edinburgh, UK.
Ian
I
Kunkler
Sandro Pitigliani Medical Oncology Unit, Hospital of Prato, Istituto Toscano Tumori, Prato, Italy.
Laura
L
Biganzoli
Department of Public Health, Erasmus University Medical Centre, Rotterdam, Netherlands.
Jacques
J
Fracheboud
Senology and Surgical Gynecologic Unit, Geneva University Hospitals, Geneva, Switzerland.
George
G
Vlastos
Medical Oncology Clinic, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
Chantal
C
Bernard-Marty
Division of Medical Oncology and Experimental Therapeutics, City of Hope, Duarte, CA, USA.
Arti
A
Hurria
H Lee Moffitt Cancer Center, University of South Florida, Tampa, FL, USA.
Martine
M
Extermann
Department of Medical Oncology, Institut Curie, Paris, France.
Véronique
V
Girre
Medical Oncology, René Huguenin Cancer Centre, Saint-Cloud, France.
Etienne
E
Brain
University of Liverpool, Whiston Hospital, Prescot, UK.
Riccardo A
RA
Audisio
Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam, Netherlands.
Harry
H
Bartelink
Agency for Healthcare Research and Quality, Rockville, MD, USA.
Mary
M
Barton
Department of Breast Medical Oncology, University of Texas M D Anderson Cancer Center, Houston, TX, USA.
Sharon H
SH
Giordano
Hematology Oncology Unit, University of Vermont and Vermont Cancer Center, Burlington, VT, USA.
Hyman
H
Muss
Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland.
Matti
M
Aapro
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001365:Axilla; D001943:Breast Neoplasms / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D019317:Evidence-Based Medicine; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D008197:Lymph Node Excision; D008403:Mass Screening / Q000379:methods*; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008495:Medical Oncology; D009362:Neoplasm Metastasis; D018714:Radiotherapy, Adjuvant; D012955:Societies, Medical; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal