Breast cancer in elderly women (>= 70 years): Which treatment?

Breast cancer is a disease that affects women >70 years of age much more fr equently than other age groups. Epidemiologic data show that more than 40% of breast cancers occur in the elderly. The optimal primary treatment for e lderly patients with breast cancer is controversial and ranges from tamoxif en as sole therapy to surgery. Despite the high prevalence of the disease, the elderly have been excluded from clinical trials mainly for the presence of concurrent medical conditions that adversely affect treatment strategie s. Since life expectancy continues to increase in western countries, an app ropriate treatment that respects quality of life needs to be determined for the elderly age group. In the light of randomised and retrospective studie s carried out to date, limited surgery without axillary dissection plus adj uvant tamoxifen seems to achieve, mainly for elderly patients with early st age breast cancer, a local-regional control rate comparable to that obtaine d with more aggressive therapeutic strategies. The results of ongoing prosp ective clinical trials will show whether or not conservative surgery withou t axillary clearance and tamoxifen may be routinely used for elderly patien ts with early breast cancer.