External radiotherapy for breast cancer in the elderly
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Breast cancer is the most common malignancy amongst elderly women and the main cause of mortality. A specific management for elderly woman is not clear because clinical trials are usually not customized for this subset of patients.
The aim of this paper is to provide an overview of the available information on the main issues in the field of breast cancer radiotherapy in the elderly population.
Materials and methods
Authors discuss on different radiation treatments for breast cancer in the elderly, based on the data of the literature with a focus on new strategy: hypo-fractionation, accelerated partial breast irradiation, and the utility of a dose boost.
The treatment of breast cancer is not standardized in the elderly. The optimal management in this population often requires complex multidisciplinary supportive care due to multiple comorbidities to optimize their cancer care.
New options such as APBI or HyRT regimens should be taken into consideration and offered as a breach of duty to the elderly population. Furthermore, they should be extensively investigated through randomized clinical trials.
KeywordsElderly Breast cancer External radiation therapy Local recurrence Survival
Early Breast Cancer Trialists’ Collaborative Group
Comprehensive Geriatric Assessment Numeric Rating Scale
National Comprehensive Cancer Network
European Society of Breast Cancer Specialists
Accelerated partial breast irradiation
Intensity-modulated radiation therapy
Volumetric modulated arc therapy
Surveillance epidemiology and end results
National Cancer Institute
Compliance with ethical standards
Conflict of interests
The authors declare that they have no conflict of interest.
For this type of study, formal consent is not required. The study does not require approval by ethics committee.
Statement of human and animal rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed consent to the radiation therapy procedure and to the processing of own personal data was obtained from each individual study participant. In accordance with Italian Drug Agency (AIFA) guidelines, observational studies using retrospective data or materials do not require formal approval by the local ethics committee.
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