• Laura Biganzoli, Nicolò Matteo Luca Battisti, Hans Wildiers, Amelia McCartney, Giuseppe Colloca, Ian H Kunkler, Maria-João Cardoso, Kwok-Leung Cheung, Nienke Aafke de Glas, Rubina M Trimboli, Beatriz Korc-Grodzicki, Enrique Soto-Perez-de-Celis, Antonio Ponti, Janice Tsang, Lorenza Marotti, Karen Benn, Matti S Aapro, and Etienne G C Brain.
• Department of Medical Oncology, Hospital of Prato, Prato, Italy. Electronic address: laura.biganzoli@uslcentro.toscana.it.
• Lancet Oncol. 2021 Jul 1; 22 (7): e327-e340.

AbstractBreast cancer is increasingly prevalent in older adults and is a substantial part of routine oncology practice. However, management of breast cancer in this population is challenging because the disease is highly heterogeneous and there is insufficient evidence specific to older adults. Decision making should not be driven by age alone but should involve geriatric assessments plus careful consideration of life expectancy, competing risks of mortality, and patient preferences. A multidisciplinary taskforce, including members of the European Society of Breast Cancer Specialists and International Society of Geriatric Oncology, gathered to expand and update the previous 2012 evidence-based recommendations for the management of breast cancer in older individuals with the endorsement of the European Cancer Organisation. These guidelines were expanded to include chemotherapy toxicity prediction calculators, cultural and social considerations, surveillance imaging, genetic screening, gene expression profiles, neoadjuvant systemic treatment options, bone-modifying drugs, targeted therapies, and supportive care. Recommendations on geriatric assessment, ductal carcinoma in situ, screening, primary endocrine therapy, surgery, radiotherapy, adjuvant systemic therapy, and secondary breast cancer were updated.Copyright © 2021 Elsevier Ltd. All rights reserved.

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