Optimal management of breast cancer in the elderly patient: current perspectives

Olivia Le Saux,1 Bertrand Ripamonti,2 Amandine Bruyas,3,4 Olivier Bonin,4 Gilles Freyer,1,4 Marc Bonnefoy,4,5 Claire Falandry4,51Medical Oncology Unit, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 2Gynaecology-Obstetrics Department, University Hospital, Saint-Etienne, 3Croix Rousse University Hospital, Hospices Civils de Lyon, Pierre-Bénite, 4Lyon University, Lyon, 5Geriatric Unit, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, FranceAbstract: Breast cancer (BC) is the most common female malignancy in the world and almost one third of cases occur after 70 years of age. Optimal management of BC in the elderly is a real challenge and requires a multidisciplinary approach, mainly because the elderly population is heterogeneous. In this review, we describe the various possibilities of treatment for localized or metastatic BC in an aging population. We provide an overview of the comprehensive geriatric assessment, surgery, radiotherapy, and adjuvant therapy for early localized BC and of chemotherapy and targeted therapies for metastatic BC. Finally, we attempt to put into perspective the necessary balance between the expected benefits and risks, especially in the adjuvant setting.Keywords: elderly, breast cancer, geriatric assessment, surgery, chemotherapy, radiotherapy