Tailored surgery for older women with breast cancer

Abstract

As the 21st century unfolds an increasing proportion of the surgical oncological workload will comprise older patients. In the USA, those over 65 years have been classified as elderly, whereas in Europe this has tended to mean individuals aged ≥70 years. These arbitrary cutoffs have had the effect of characterizing those over a certain age as being somehow unsuited to standard cancer treatment without taking into account the variations in biological behavior of patients and their tumors. Attitudes have changed. Having moved from the belief that breast cancer is inevitably a slow-growing disease in older women, many surgeons and radiation oncologists now accept that treatment should be based upon the characteristics of the patient and her tumor. Since evidence has accumulated from studies that have focused on older patients, it is timely to reconsider local options for effective treatment and determine whether this can be tailored to age. © Springer-Verlag Berlin Heidelberg 2006.