Breast Cancer in Older Women: What You Should Know
Breast cancer in elderly women presents a significant challenge for modern healthcare. The average age at diagnosis is around 62 years, with 25% of cases occurring in women aged 75-84. Projections indicate that by 2030, breast cancer cases will double, with most new diagnoses in women aged 70-84.
Why Age Alone Isn’t Enough
Despite the increasing incidence, there are no clear international guidelines specifically for managing breast cancer in older women. This is largely because older age groups are often excluded from clinical trials, limiting data on treatment efficacy and safety.
Age alone should not determine treatment decisions. The patient's overall health, comorbidities (e.g., hypertension, diabetes, cardiorespiratory diseases), as well as tumor characteristics (e.g., hormone receptors, extent, aggressiveness) and the patient's personal wishes are equally critical.
Balancing Under- and Overtreatment
In older ages, application is often observed less aggressive treatment, which may negatively affect the prognosis. On the other hand, the overtreatment – that is, the use of intense therapeutic interventions without absolute indication – can cause serious side effects without substantial benefit, especially when the likelihood of disease recurrence is lower than the threat posed by other health problems.
The personalization of treatment is the key to safe and effective treatment of breast cancer in older women.
Diagnosis: The Role of Biopsy
Biopsy under local anesthesia remains essential for treatment planning, providing critical information on:
- Hormone receptor status (ER, PR)
- HER2 status
- Tumor grade
- Proliferation index (Ki-67)
This data is necessary for downloading targeted and safe decisions.
Surgery in Healthy Elderly Patients
The lumpectomy is often the preferred surgical method, especially when the lesion is not extensive, as it is associated with faster recovery and fewer complications. Axillary lymph node dissection, radiation, and systemic therapies (chemotherapy, hormone therapy, immunotherapy) are decided based on:
- Overall health
- Disease extent
- Tumor biology
- Patient preferences
Hormone Therapy: A Gentle and Effective Ally
In cases with hormone-dependent tumors, it may be administered preoperative hormone therapy to shrink the tumor, in order to avoid extensive surgery. Correspondingly, in small tumors, radiation or surgery to the armpit may be omitted, provided that postoperative hormone therapy is planned.
When Surgery Isn’t an Option
In women who are either not medically fit or do not wish to undergo surgery, the hormone therapy is a well-tolerated and effective solution – as long as the disease is hormone-dependent. If the tumor does not have hormone receptors, then the treatment option (chemotherapy or simple observation) is determined based on the woman's symptoms and needs.
In summary
Breast cancer at an advanced age it requires sensitivity, knowledge and individualization. The right approach is not less or more treatment, but appropriate treatment for the right woman, at the right time. Understanding the specifics of each case leads to a better quality of life and more effective treatment of the disease.
At breastaware.gr you’ll find reliable, scientifically grounded, and compassionate information on all aspects of breast health. Our mission is to empower every woman with knowledge, care, and support at every age and stage of life.
Bibliography:
- National Cancer Institute SEER Data, 2023
- Wildiers H et al. Management of breast cancer in elderly individuals: recommendations of the International Society of Geriatric Oncology (SIOG) and EUSOMA. Lancet Oncol. 2021.
- Biganzoli L et al. European School of Oncology – ESO and ESMO Breast Cancer in Elderly Guidelines, 2023
- NCCN Guidelines Version 4.2025 – Breast Cancer
