Management of breast cancer in elderly patients

SUMMARY: Despite 40% of breast cancers being diagnosed in women older than 65 years of age in developed countries, we are far from fully understanding the biology and optimizing treatment for this rapidly expanding age group. According to recent statistics, breast cancer mortality rates have decreased in recent years for younger women, while elderly patients have not enjoyed such an improvement. Older patients have peculiar characteristics, due to the presence of comorbidities, competitive causes of death, frailty, polypharmacy, deranged cognitive and nutritional status, and psychosocial problems; for these reasons older women need tailored treatment planning, which poses a barrier to their recruitment into clinical trials. Targeted research is urgently needed for these patients, either through prospective investigations or large and good quality epidemiological studies.