Epidemiology of breast cancer in older women - Implications for future healthcare

Breast cancer in elderly women is already a significant public health probl em. Elderly women have a 6-fold higher breast cancer incidence rate and 8-f old higher mortality rate compared with non-elderly women. Because of demog raphic trends, the number of elderly women diagnosed with breast cancer is likely to increase substantially in the coming decades. Specifically, if in cidence rates remain constant, we project a 72% increase in the number of e lderly women in the US diagnosed with breast cancer by 2025, an increase fr om approximately 89 500 in 1998 to almost 154 000 in 2025. If this projecti on holds true, the sheer magnitude of the increase in patients has profound implications for the delivery of medical care. Considerable planning is ne eded to ensure that the infrastructure is in place to effectively treat the se patients. The burgeoning number of elderly patients with breast cancer a ccentuates the need for more definitive evidence concerning preventing and treating breast cancer in the elderly. Treatment patterns for elderly patients with breast cancer have been shown to differ from those for non-elderly patients, but the evidence base for di fferentiating treatment plans by age is deficient. For example, information is needed to tease apart the relative importance of age per se compared wi th important age-related factors, such as comorbidity. Patient care will be nefit from an interdisciplinary team approach that includes oncologists, ge riatricians, surgeons, radiation oncologists, nurses and social workers. The continued increase in life expectancy necessitates well-crafted strateg ies for the primary and secondary prevention of breast cancer. Carefully ad dressing the priorities for breast cancer prevention and control in the eld erly during the first portion of the century may reap substantial dividends by the end of the century.