Optimising care of elderly breast cancer patients: a challenging priority.

Elderly breast cancer patients comprise almost 50% of the breast cancer population. The unique needs of this population are discussed. Therapeutic challenges facing clinicians include the absence of the ideal method to assess these patients' fitness to receive therapy, to anticipate probable side-effects and to predict survival. In addition, there are few guidelines to assist decision-making, as historically clinical trials have excluded such individuals. Evidence for the use of chemotherapy, endocrine therapy and newer targeted therapies in the elderly is summarised. Special safety considerations in the elderly are highlighted and current practice and ongoing research are reviewed.