Abstract
Currently, the growing population of the elderly is one of biggest problems in terms of increase in geriatric diseases. Lack of data from large prospective studies on geriatric breast cancer patients often makes it difficult for clinicians to make treatments decisions for them. Because both benefit and risk of treatment should be taken into account, treatment is usually determined considering life expectancy or comorbidities in elderly patients. Treatment of breast cancer is differentiated according to histologic classifications, and hormone therapy is even adopted for patients with metastatic breast cancer if tumor tissue expresses hormone receptors. Endocrine therapy can offer great benefit to elderly patients considering its equivalent efficacy to chemotherapy with fewer toxicities if it is appropriately used. Aromatase inhibitors are usually prescribed agents in hormone therapy for elderly breast cancer patients due to their physiology after menopause. Here, endocrine therapy for elderly patients with breast cancer in neoadjuvant, adjuvant, and palliative setting is reviewed along with predictive adverse events resulting from the use of hormone agents.
Highlights
IntroductionA growing number of patients with geriatric diseases including cancers have become issues of public health
With increasing life expectancy, a growing number of patients with geriatric diseases including cancers have become issues of public health
Recent data on breast cancer statistics have shown an improvement of long-term mortality from breast cancer in all age groups from 1989 to 2012 largely due to progress in treatment and early detection through screening [1, 4], but the range of improvement is much smaller in elderly women aged over 70 years (1.5% per year) than that in young women aged 20 to 39 years (2.8% per year) [1]
Summary
A growing number of patients with geriatric diseases including cancers have become issues of public health. More than 30% of patients with breast cancer are diagnosed at age over 70 years, and recent data suggest continuous increase of breast cancer incidence rates in women in their 60s (1.0% per year since 2004) and women older than 70 years (1.2% per year since 2005) [1]. As the population of elders is expected to grow continuously, 20% of the population is estimated to be at age of 65 years or more by 2030 [3], which will lead to increased number of elderly patients with breast cancer. For physiologic reason of menopausal women, aromatase inhibitors (AIs) are often chosen as endocrine therapy agents in geriatric patients with breast cancer expressing hormone receptors. We reviewed the hormone therapy as neoadjuvant, adjuvant, and palliative therapy in elderly patients with breast cancer
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