Early breast cancer in the older woman.
Early breast cancer in the older woman.
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DOI：
10.1016/j.cger.2011.10.002
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发表时间：
2012-02
影响因子：
3.3
通讯作者：
Hurria A
中科院分区：
文献类型：
--
作者：
VanderWalde A;Hurria A
乳腺癌是一种与年龄相关的疾病；随着年龄的增长，乳腺癌的发病率和死亡率都会上升。随着美国人口老龄化，被诊断患有乳腺癌的老年人人数和乳腺癌幸存者人数都在上升。大多数乳腺癌病例被诊断为早期(非转移性)有可能治愈的疾病。本文将回顾老年人早期乳腺癌的治疗，包括手术、放射治疗、内分泌治疗、化疗和曲妥珠单抗的风险和益处。尽管到目前为止的大多数研究表明，与年轻人相比，老年人从大多数多模式治疗乳腺癌中获得的好处相似，但这些研究主要是在健康和健康的老年人中进行的。在年龄的极端情况下，或者在那些有明显的合并症或功能下降的患者中，数据有限。医生和患者面临的一个主要问题是，乳腺癌是否可能影响患者的预期寿命或生活质量。如果是这样，那么必须考虑治疗的风险和好处，并根据患者的喜好做出关于治疗的最终决定。本文将对早期乳腺癌常见癌症治疗方法的短期和长期毒性进行综述。最后，二次筛查的类型和预防未来乳腺癌的决定也必须与老年人的预期寿命进行权衡。
Breast cancer is a disease associated with aging; there is a rise in both breast cancer incidence and mortality with increasing age. With the aging of the US population, the number of older adults diagnosed with breast cancer and the number of breast cancer survivors is on the rise. The majority of cases of breast cancer are diagnosed with early stage (non-metastatic) potentially curable disease. This article will review the treatment of early stage breast cancer in older adults including a focus on the risks and benefits of surgery, radiation therapy, endocrine therapy, chemotherapy, and trastuzumab. Although the majority of studies to date demonstrate that older adults experience similar benefits from most multimodality treatments for breast cancer as compared to younger adults, these studies have primarily been performed in healthy and fit older adults. There are limited data at the extremes of age or in those patients with significant comorbidity or functional decline. A primary question facing the doctor and patient is whether the breast cancer is likely to impact the patient’s life expectancy or quality of life. If so, then the risks and benefits of treatment must be considered with a final decision regarding therapy made in the context of the patient’s preferences. This article will review the toxicities (both short- and long-term) from common cancer therapies in early breast cancer. Finally, the decision as to type of secondary screening and prevention of future breast cancers must also be weighed against the life expectancy of the older adult.
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