老年人乳腺癌

老年人乳腺癌与年轻人乳腺癌相比,恶性程度相对较低。临床以局部性或局部晚期癌较多。因老年患者生理变化,且常同时伴有其他疾病,治疗原则应选择对患者创伤及不良反应最小而能获得最大疗效的综合治疗,除基于疾病的分期外,要注重了解乳腺癌的生物学特征、患者体力情况、重要脏器器官功能及对拟定疗法的耐受能力。手术是可手术乳腺癌主要治疗手段之一,早期乳腺癌ER( )者,采用肿瘤局部扩大切除或加前哨淋巴结活检术(SLNB),术后加或不加放疗,辅助以内分泌治疗可达到满意控制肿瘤效果。局部晚期乳腺癌或肿瘤较大,ER( )者,可采用第三代芳香化酶抑制剂(3rdAI)行新辅助内分泌治疗,肿瘤缩小后采用缩小手术切除范围术式。对全身复发、转移高危及ER(-)患者,如体力情况尚好,可化疗。

Breast cancer in older women

Breast cancer in the elderly seems to be less aggressive than in the younger patients.Older women tend to have more localized disease or locally advanced breast cancer.Older women more frequently have phgsiological changes as well as concurrent disease that planning may limit the choice of therapy.Patient's performance status and tumor's biologic behavior should be considered when primary treatment of breast cancer other than tumor stage at presentation.Surgical operation is one of the major means for the treatment of operable breast cancer.In early breast cancer women who have ER-positive tumor that can be treated with breast conservation,or with sentinel node biopsy followed by breast irradiation and endocrine therapy,or without breast radiation.The patients with locally advanced breast cancer or who have larger,ER-positive tumor,or clinically-positive axillary nodes can be given preoperative endocrine therapy with 3~(rd) generation of aromatase inhibitors to try to convert to limited surgery.Adjuvant chemotherapy can be considered for older women with ER-negative tumor whose risk of systemic recurrence is high and who are in good health.Strict adherence to indications of adjuvant radiotherapy should be carried out for older women with breast cancer.