title: Therapeutic management of breast cancer in the elderly.
abstract: BACKGROUND
  Over the last few decades, the population of developed countries has aged. Breast cancer is the most common cancer among the increased numbers of older women. The choice of adjuvant treatment is particularly difficult in older women because the oncologist has to balance reduction of the risk of recurrence with patient-related comorbidities that may increase the risk of treatment-related toxicity and influence patient survival.
  
  
  METHODS
  This article describes the concept of a comprehensive geriatric assessment and reviews the current literature on biological and pathological characteristics of breast cancer in the elderly, including genomic assays recently available in the clinic. Endocrine, targeted and chemotherapy treatments both in adjuvant and metastatic setting are also covered.
  
  
  CONCLUSIONS
  A new generation of studies aimed to re-evaluate treatments in the various subtypes of breast cancer is needed. Whether this will be possible through prospective studies (especially in the adjuvant setting) is unknown. An alternative direction for further research in the elderly could be a reappraisal of old studies with carefully planned subtype analyses. Whatever the direction, the management of elderly breast-cancer patients is inherently multidisciplinary: the contribution of medical and allied health professionals is essential to the provision of optimal care.
authors.affiliation: Centro di Riferimento Oncologico, CRO-IRCCS-Medical Oncology C, Via F. Gallini 2, Aviano (Pordenone) 33081, Italy. spazzapan@cro.it
authors.forename: Simon
authors.initials: S
authors.lastname: Spazzapan
authors.forename: Diana
authors.initials: D
authors.lastname: Crivellari
authors.forename: Philippe
authors.initials: P
authors.lastname: Bedard
authors.forename: Davide
authors.initials: D
authors.lastname: Lombardi
authors.forename: Gianmaria
authors.initials: G
authors.lastname: Miolo
authors.forename: Simona
authors.initials: S
authors.lastname: Scalone
authors.forename: Andrea
authors.initials: A
authors.lastname: Veronesi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000235:genetics / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008017:Life Expectancy
chemical_list: D000970:Antineoplastic Agents