Abstract: Breast cancer is the most common cancer diagnosed among women worldwide and more than half are diagnosed above the age of 60 years. Life expectancy is increasing and the number of breast cancer cases diagnosed among older women are expected to increase. Undertreatment, mostly due to unjustifiable fears of advanced-age and associated comorbidities, is commonly practiced in this group of patients who are under-represented in clinical trials and their management is not properly addressed in clinical practice guidelines. With modern surgery and anesthesia, breast surgeries are considered safe and is usually associated with very low complication rates, regardless of extent of surgery. However, oncoplastic surgery and management of the axilla can be tailored based on patients’- and disease-related factors. Most of chemotherapeutic agents, along with targeted therapy and anti-Human epidermal growth factor receptor-2 (HER2) drugs can be safely given for older patients, however, dose adjustment and close monitoring of potential adverse events might be needed. The recently introduced cyclin-D kinase (CDK) 4/6-inhibitors in combination with aromatase inhibitors (AI) or fulvestrant, which changed the landscape of breast cancer therapy, are both safe and effective in older patients and had substituted more aggressive and potentially toxic interventions. Despite its proven efficacy, adjusting or even omitting adjuvant radiation therapy, at least in low-risk older patients, is safe and frequently practiced. In this paper, we review existing data related to breast cancer management among older patients across the continuum; from resection of the primary tumor through adjuvant chemotherapy, radiation and endocrine therapy up to the management of recurrent and advanced-stage disease.

Keywords: breast cancer, age, elderly patients, geriatric


中文翻译：

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老年患者的乳腺癌：现状和未来前景

摘要：乳腺癌是全世界女性中诊断出的最常见的癌症，超过一半在 60 岁以上被诊断出。预期寿命正在增加，预计老年妇女中诊断出的乳腺癌病例数将增加。治疗不足，主要是由于对高龄和相关合并症的不合理恐惧，通常在这组临床试验中代表性不足的患者中实施，并且在临床实践指南中没有适当地处理他们的管理。通过现代手术和麻醉，乳房手术被认为是安全的，并且通常与非常低的并发症发生率相关，无论手术范围如何。然而，腋窝的肿瘤整形手术和管理可以根据患者和疾病相关因素进行调整。大多数化疗药物，除了靶向治疗和抗人表皮生长因子受体 2 (HER2) 药物外，老年患者可以安全地使用，但可能需要调整剂量并密切监测潜在的不良事件。最近推出的 cyclin-D 激酶 (CDK) 4/6-抑制剂与芳香化酶抑制剂 (AI) 或氟维司群联用，改变了乳腺癌治疗的前景，对老年患者既安全又有效，并取代了更具侵略性和潜在的毒性干预。尽管其已被证实有效，但至少在低风险老年患者中调整甚至省略辅助放射治疗是安全且经常实施的。在本文中，我们回顾了与整个连续体中老年患者乳腺癌管理相关的现有数据；从原发肿瘤切除到辅助化疗，

【关键词】：乳腺癌 年龄 老年患者