Radiotherapy issues in elderly breast cancer patients.

摘要: Breast cancer in the elderly is a rising health care challenge. Under-treatment common. While proportion of older patients receiving adjuvant radiotherapy (RT) rising, undergoing breast-conserving surgery without irradiation has also risen. The evidence base for loco-regional treatment limited, reflecting historical exclusion from randomised trials. 2011 Oxford overview shows that risk first recurrence halved all age groups by RT after surgery, although absolute benefit 'low-risk' small. There level 1 breast boost and whole-breast reduces local as younger women, former reduction modest. Partial (external beam or intraoperative postoperative brachytherapy) potentially an attractive option patients, but insufficient to recommend it routinely. Similarly, shortened (hypofractionated) dose fraction schedules may be more convenient are supported evidence. remains uncertainty about whether there subgroup low-risk whom can omitted surgery. Biomarkers 'low risk' needed refine selection omission RT. role postmastectomy well established 'high-risk' uncertain intermediate-risk category with 1-3 involved axillary nodes node-negative other factors where its investigational.