Onkológia 6/2020

Primary treatment of breast cancer in old women

Age is the most important risk factor for most types of adult cancer, including breast cancer. About half of all cases of breast cancer are diagnosed over the age of 65. In addition to the calendar age, however, it is always necessary in elderly women to consider their biological age and functional status. Therapeutic approach should balance the efficacy and safety to avoid further unnessecarry harm with the rigorous application of the recommendations derived from studies in younger subjects, but, on the other hand, any reduction of the intensity of the treatment should not substantially worsen the prospect of achieving remission. Treating elderly women is thus definitely a challenge and requires experience. The fact that this population is often excluded from clinical trials also remains a problem, and therefore in many cases treatment cannot rely on evidence-based recommendations. Only recently the situation slightly improved, and some recent or ongoing clinical studies focus exclusively on the population of elderly women, or at least the recruitment has no age restrictions.

Keywords: calendar age, biological age, breast cancer, chemotherapy, radiotherapy, target treatment, hormonotherapy