Breast Cancer in the Older Adult

Breast cancer is the most common cancer among women over the age of 65 years. The objectives of this chapter are to review the value of clinical assessment tools for older adults with breast cancer and to discuss breast cancer prevention, screening, and treatment specific for older adults. The geriatric assessment is an important tool that oncologists can use to better assess an older adult’s functional age and provides additional information beyond standard performance status measures. The geriatric assessment has been shown to uncover problems not detected in a routine oncologic evaluation and also aids in predicting treatment-related toxicity in older adults with solid tumors. Healthy older women with breast cancer should be managed like younger postmenopausal women, including breast conservation therapy if feasible and adjuvant systemic therapy. Frail older women and those with significant comorbidity frequently require treatment modifications. Older women with breast cancer should be routinely encouraged to participate in clinical trials to further develop evidence-based practices for the management and treatment of breast cancer in older adults.