Adjuvant radiotherapy

Abstract

The goal of cancer care for elderly patients with breast cancer should include a plan for long-term control of the cancer (cure), maintenance of a maximum level of patient independence, freedom from symptoms, and maintenance of personal dignity and lifestyle (Wanebo et al. 1997). Radiotherapy (RT) after breast conserving surgery (BCS) or after mastectomy (post-mastectomy radiotherapy or PMRT) achieves improved local control and better survival than surgery alone, independent from other adjuvant interventions (Clarke et al. 2005). However, up to 30% of all breast cancer cases are reported to occur in patients over 70 years of age (Sader et al. 1999), a group that has often been excluded from the trials that have contributed to establishing the current standard of care. Although available age-specific clinical trials data demonstrate that treatment efficacy is not modified by age, this evidence is limited by the lack of inclusion of substantial numbers of older women, particularly those of advanced age and those with co-morbidities. © 2010 Springer-Verlag London.