Breast cancer in older women

Due to the increase in life expectancy in Chile, more than 10% of the population is 60 years or older. Since the incidence of most cancers increases with age, one of every two men and one in three women will develop a malignancy during their lifetime. In Chile breast cancer is the first leading cause of death from cancer among women. Its detection in postmenopausal women has steadily increased since the eighties, due to the expanded use of mammography. Less than 10% of patients participating in randomized controlled trials for the treatment of breast cancer, are older than 60 years, despite the fact that biological characteristics of breast cancer in older women are different and that most patients with breast cancer are of that age. Due to the high incidence of estrogen receptor positive tumors in this age group, most patients are candidates for hormone therapy. However, in those who need chemotherapy, therapeutic decisions are based on the existence of concomitant diseases and the tolerance to cytotoxic therapy. We review the relationship between age and cancer, the particular characteristics of breast cancer in older women and the alternatives of treatment with chemotherapy in advanced disease. (Rev Med Chile 2012; 140: 649-658).