The incidence of breast cancer increases dramatically with age. Given the demographic changes occurring in the United States, the number of elderly women developing breast cancer will continue to rise. Older women as a group have…

Numerous studies have documented that there are significant treatment differences in older patients compared to younger patients. Elderly women with early-stage breast cancer are less likely to undergo breast-conserving surgery than younger women, despite…

A number of studies suggest that older women adjust to breast cancer better than younger women. In a study of 304 women immediately after completion of therapy for…

Metastatic breast cancer is incurable with currently available therapies. Median survival ranges from 2 to 3 years; however, there is substantial variability in survival, with as many as 10% of patients living more than…

Decisions regarding adjuvant therapy should take into account a woman’s risk of disease recurrence, her life expectancy, the benefits and risks of each treatment, and her preferences. Adjuvant tamoxifen clearly reduces the risk of recurrence and…

The role of adjuvant chemotherapy in older women is controversial. Although earlier trials showed minimal benefit in older women, recent larger trials and the Oxford overview analyses have revealed that adjuvant chemotherapy results in modest benefits…

Tamoxifen is an oral synthetic antiestrogen. It is believed to exert its antiestrogenic activity primarily by competitively blocking the binding of estradiol to the estrogen receptor. When estrogen combines with the estrogen receptor in the cell…

Despite advances in local therapy, a substantial proportion of women with early-stage disease will not be cured with local treatment alone. Ten-year disease-free survival rates for patients treated with radical mastectomy alone are shown…

For most older women, treatments offered should be similar to those considered for younger women. However, alternative, less aggressive approaches to local therapy have been sought for older women, particularly for…

Axillary nodal status is the single best predictor of overall survival in women with breast cancer. The presence or absence of lymph node involvement has been an important determinant for the use of…

Breast irradiation following breast-conserving surgery significantly decreases the risk of recurrence in the breast. In the NSABP B-6 trial, breast irradiation following breast-conserving surgery in women age 70 or younger…

Local Therapy

Local treatment refers to treatment directed at the breast and regional lymph nodes. Local treatment alone can be curative in the majority of patients with stage I breast cancer and…

Ductal carcinoma in situ (DCIS) in a noninvasive form of breast cancer in which tumor cells are confined to the ductolobular system and surrounded by an intact basement membrane. If left…

Disease status, comorbidity, life expectancy, patient preferences, and goals of therapy should guide treatment of an older patient with breast cancer. These decisions should be made with an understanding of the treatment regimens that have been…

Significant research over the past three decades has focused on the screening, early detection, and treatment of breast cancer. More recently, efforts have focused on primary prevention, particularly in women who are deemed…

Normal breast tissue changes with age. The dense fibrous and glandular breast tissue of early adulthood is replaced by increasing amounts of fat as a woman ages.…

For years, investigators have attempted to understand the clustering of breast cancer that occurs in certain families. Familial breast cancer has been characterized by an earlier average age of onset, an increased risk of…