Breast Cancer Care in Old Age: Where Do We Go From Here?

Breast cancer is a disease primarily of older women. The cumulative risk for this disease reaches its maximum well into the ninth decade of life (7). It is also a serious disease in older women. The approximate 10-year risk of disease recurrence for women 70 years of age or older who are lymph node negative with 1- to 5-cm tumors is 20%-30%; the risk for women with one to three positive lymph nodes and tumors of any size is 50%; the risk for women with four or more positive lymph nodes and tumors of any size is 80 % (2). These risks are espe-cially clinically relevant because recent gains in life expectancy have occurred at the end of life: The average life expectancy of an 85-year-old woman is nearly 6.5 years (3). During the past decade, several studies (4-9) have docu-mented age-related variations in care among patients with early stage breast cancer. These studies were conducted in a variety o