| Systemic Treatment of Older Patients with Advanced Breast Cancer |
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Kyung Ah Yoh, Jee Hyun Kim |
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Department of Internal Medicine, Seoul National University College of Medicine, Seoul; Division of Hematology and Medical Oncology, Seoul National University Bundang Hospital, Seongnam, Korea |
| 진행성 노인 유방암에 대한 항암요법 |
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여경아, 김지현 |
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서울대학교 의과대학 분당서울대학교병원 혈액종양내과 |
Correspondence:
Jee Hyun Kim, Tel: +82-31-787-7022, Fax: +82-31-787-7048, Email: jhkimmd@snu.ac.kr
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| This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/licenses/bync/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Abstract |
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Due to its increasing incidence and longer life expectancy, more patients are being diagnosed with breast cancer at older ages. There are very limited data on the optimum management of older patients with advanced breast cancer, due to the under-representation of such individuals in clinical trials. Although older patients have more indolent disease with more Hormone Receptor positive disease and less HER2-positive disease, their disease-specific mortality remains lower than in younger patients, owing to the late diagnosis, under treatment due to age bias, reduced access to healthcare, and socioeconomic issues. Older patients with advanced breast cancer should be treated based on their biological tumor type, according to the patient’s general health and preferences: endocrine treatment for HR-positive disease; Human Epidermal Growth Factor Receptor 2-targeted agent with chemotherapy, endocrine therapy or HER2-targeted agent alone for HER2 positive disease. Chemotherapy should be considered for patients who are HR-negative, HR-positive but refractory to endocrine treatment, or with a rapidly progressing visceral crisis. Generally, sequential chemotherapy with a single agent is recommended over combination chemotherapy, and agents with known toxicities in older patients are recommended, including weekly taxane, vinorelbine, capecitabine, and liposomal doxorubicin. Some form of geriatric assessment should be performed for older patients to assess the patients’ biological age, functional status, and address age-specific problems, leading to early interventions. The goal of therapy should be individualized to maintain the quality of life, function, and independence of older patients with cancer. |
| Key Words:
Elderly; Breast cancer; Chemotherapy |
| 주제어:
노인; 유방암; 항암요법 |
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