Author:

Abstract:

Breast cancer in elderly patients (70+) is a major health problem which will only increase in the future. Besides adequate local treatment and hormone therapy, chemotherapy may be indicated in this patient group. A comprehensive geriatric assessment is indispensable for an adequate judgement of the advantages (improved quality of life and life expectancy) and disadvantages (toxicity) of chemotherapy. Taking into account the aging related physiological changes, leading to altered pharmacokinetic and - dynamic properties of anticancer drugs, it is perfectly feasible to safely administer chemotherapy to a large part of the elderly breast cancer population, with the same advantages as for the younger patients. In adjuvant setting, only sparse data on the benefit of chemotherapy are available; we are awaiting the results of large ongoing trials. In metastatic setting, newer regimens like weekly taxanes, capecitabin, or vinorelbin, are used with limited toxicity and a good chance of subjective benefit and tumor response. The defeatist attitude towards chemotherapy in elderly patients, present in a large part of patients and even doctors, should be abandoned.