• Vol. 48 No. 11, 370–375
  • 15 November 2019

Personalising Care in the Older Woman with Primary Breast Cancer



The incidence of breast cancer increases with age. Despite this, most research in the field is targeted at younger patients. Age-specific guidelines are not widely referred to and guidelines which allude to the older woman as an individual are based solely on conventional factors. This creates a problem for older women with primary operable breast cancer who are not fit, too frail or do not wish to have surgery. Preliminary studies have shown that older women with breast cancer have distinct biological features compared to their younger counterparts. This means that they are likely to have less aggressive cancers such as those who are oestrogen receptor-positive. Geriatric assessment (GA) has been used in clinical practice to identify patients that are suitable for certain treatments. More research on this group of patients’ unique biological features and GA will help tailor personalised care for them.

The 2 main challenges in initial management of primary breast cancer, at diagnosis, are as follows: 1) Which patients with oestrogen receptor (ER)-positive tumours should receive surgery versus primary endocrine therapy (PET)? (Breast cancer in older women tends to be ER-positive and human epidermal growth factor receptor 2-negative.

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