Adjuvant treatment of breast cancer in the older patients

Breast cancer has a high incidence and it ranks first as cancer-related deaths among European women. Moreover its incidence increases 1000 times from the age of 40 to the age of 80. On the whole, 50-60% of all new cases of breast cancer are diagnosed in women 65 years and older and about 40% in women older than 70. The combination of an expanding geriatric population with the increasing incidence with age of breast cancer will have a great clinical and social impact in the coming years. This article addresses issues concerning the systemic therapy of early stage breast cancer. Based on the results of the hormonal treatment with tamoxifen, it is concluded that adjuvant treatment is suitable for elderly patients with breast cancer, including frail women non eligible for surgery and chemotherapy. Tamoxifen for 5 years remains the standard treatment, while the role of chemotherapy is still to be elucidated.