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.
Wildiers
Hans
H
Department of General Medical Oncology, University Hospital Gasthuisberg, Leuven, Belgium. Electronic address: hans.wildiers@uzleuven.be.
Kunkler
Ian
I
Edinburgh Cancer Centre, University of Edinburgh, Edinburgh, UK.
Biganzoli
Laura
L
Sandro Pitigliani Medical Oncology Unit, Hospital of Prato, Istituto Toscano Tumori, Prato, Italy.
Fracheboud
Jacques
J
Department of Public Health, Erasmus University Medical Centre, Rotterdam, Netherlands.
Vlastos
George
G
Senology and Surgical Gynecologic Unit, Geneva University Hospitals, Geneva, Switzerland.
Bernard-Marty
Chantal
C
Medical Oncology Clinic, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
Hurria
Arti
A
Division of Medical Oncology and Experimental Therapeutics, City of Hope, Duarte, CA, USA.
Extermann
Martine
M
H Lee Moffitt Cancer Center, University of South Florida, Tampa, FL, USA.
Girre
Véronique
V
Department of Medical Oncology, Institut Curie, Paris, France.
Brain
Etienne
E
Medical Oncology, René Huguenin Cancer Centre, Saint-Cloud, France.
Audisio
Riccardo A
RA
University of Liverpool, Whiston Hospital, Prescot, UK.
Bartelink
Harry
H
Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam, Netherlands.
Barton
Mary
M
Agency for Healthcare Research and Quality, Rockville, MD, USA.
Giordano
Sharon H
SH
Department of Breast Medical Oncology, University of Texas M D Anderson Cancer Center, Houston, TX, USA.
Muss
Hyman
H
Hematology Oncology Unit, University of Vermont and Vermont Cancer Center, Burlington, VT, USA.
Aapro
Matti
M
Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland.
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