Abstract
The treatment of breast cancer in the elderly population requires a tailored approach. We summarize the current best evidence for personalized local-regional therapy in breast cancer patients older than 70. Breast cancer treatment in older adults incorporates the use of geriatric assessment tools to best evaluate functional status and treatment tolerability while accounting for the biologic profile of the disease. Surgical resection of the primary tumor with lymph node evaluation remains the cornerstone of local-regional control. Recent clinical trials demonstrate that surgery and radiation therapy may, however, be safely omitted in selected patients who are eligible for primary endocrine therapy. In patients with high-risk node-positive disease, DFS can be improved by systemic chemotherapy, but potential toxicity should be carefully considered in this population. Patient-specific evaluation of the risks of both under- and over-treatment of breast cancer in the older adult is essential for delivering optimal care in this population.
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