Breast Cancer (Mammary Carcinoma): Adjuvant Therapy for Older Women

Radiotherapy

In patients without significant comorbidities, radiotherapy (radiation therapy) should usually follow BET (breast-conserving therapy) as well as mastectomy (removal of the mammary glands) with advanced tumor stage. Patients limited by comorbidities (concomitant diseases) should receive limited therapy.

Endocrine therapy

Systemic endocrine therapy (hormone therapy) can be given without restriction to older patients limited by comorbidities, but potential side effects must always be considered. In cases of comorbidity, endocrine therapy may be the alternative to surgery.

Chemotherapy

  • Chemotherapy should be given to hormone receptor-negative, triplenegative* , and HER2-positive patients.
  • Standard chemotherapy should be given to patients up to 70 years of age without significant concomitant disease.
  • In older patients with concomitant disease, chemotherapy should be offered as part of a trial, if appropriate.

Note: The prognosis of metastatic triple-negative breast carcinoma promises to improve with immunotherapy with checkpoint inhibitors.

Monoclonal antibodies

In older patients without significant concomitant disease, a combination of chemotherapy plus the monoclonal antibody trastuzumab may be used if Her2 overexpression is detected.

Participation in trials should be explained to all elderly patients.