Breast Cancer in the Elderly

Moderator: Gretchen M. Ahrendt, MD, FACS (University of Colorado-Denver), Susan K. Boolbol, MD (Beth Israel Medical Center and St. Lukes-Roosevelt Hospital Center)

Presenting Fellows: Alison Barron, MD (Mayo Clinic), Abby Geletzke, MD (Women and Infants), Sylvia Reyes, MD (University of Pennsylvania), and Arsalan Salamat, MD (University of Pittsburgh)

Suggested reading materials:

Scenario 1: Radiation therapy is recommended for local management of Stage I ER+ breast cancer in women over the age of 70

Articles to support Scenario 1:
Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): a randomized controlled trial

Effectiveness of radiation for prevention of mastectomy in older breast cancer patients treated with conservative surgery.

Lumpectomy plus tamoxifen with or without irradiation in women age 70 or older with early breast cancer: Long-Term Follow-Up of CALGB 9343

Articles not supporting Scenario 1:
Lumpectomy Plus Tamoxifen With or Without Irradiation in Women Age 70 Years or Older With Early Breast Cancer: Long-Term Follow-Up of CALGB 9343

A randomised controlled trial of post-operative radiotherapy following breast-conserving surgery in a minimum-risk population. Quality of life at 5 years in the PRIME trial

Scenario 2: Sentinel node biopsy should routinely be performed in women over the age of 70 with Stage I ER+ breast cancer and a clinically negative axilla.

Articles to support Scenario 2:
Adjuvant Chemotherapy in Older and Younger Women With Lymph Node–Positive Breast Cancer

Breast Cancer Among the Oldest Old: Tumor Characteristics, Treatment Choices, and Survival

Improvement in Breast Cancer Outcomes Over Time: Are Older Women Missing Out?

Articles not supporting Scenario 2:
Association of LN Evaluation with Survival in Women Aged 70 Years or Older With Clinically Node-Negative Hormone Receptor Positive Breast Cancer

Five Things Physicians and Patients Should Question

Predicting Nodal Positivity in Women 70 Years of Age and Older with Hormone Receptor-Positive Breast Cancer to Aid Incorporation of a Society of Surgical Oncology Choosing Wisely Guideline into Clinical Practice

Suggested viewing materials: