Anne-Chantal Braud, Institut Paoli Calmettes, Marseille, France,
Martine Extermann, MD, H. Lee Moffitt Cancer Center and Research Institute and the University of South Florida, Tampa, FL,USA.
Half of breast cancers occur in patients older than 65 and 25% in patients aged 75 or older. Prevention and early diagnosis are a societal but also an individual issue in this population. Good guidelines for screening and prevention are available for patients up to 70, but few data are available for older patients. The present article reviews these data in an effort to provide some guidance to geriatricians and primary physicians about screening and prevention of breast cancer in their older patients. Age alone should not be used to determine when to screen; rather, life expectancy estimates can help decision-making. Patients with a life expectancy of 10 years or more are likely to benefit from mammography screening. Very few data are available for tamoxifen prevention in women older than 70. There is a need for further randomized controlled trials to clarify a host of outstanding issues in improving the prevention and the care of breast cancer in older people.
Key words: older women, breast cancer, mammography, prevention.