A vision to optimise the management of primary breast cancer in older women.

Majority of breast cancer are diagnosed at >65 years. Efforts to develop clinical service and research are spent mainly on younger patients. Little is known about the biology and long-term clinical outcome of breast cancer in the elderly. However there is data suggesting that there are differences. Knowledge related to breast cancer in the elderly is urgently needed and we need to optimise their management - not 'over' or 'under' treating them, taking into account of both physical and psychosocial dimensions. The Nottingham Breast Services established a dedicated elderly primary breast cancer service from its inception over 30 year ago, which has recently developed into a combined surgical/oncology facility. A joint effort and team approach are required in both developing clinical service and research, in order to optimise management. There is an immense need to develop a dedicated elderly breast cancer service and to support ongoing research. Copyright 2010 Elsevier Ltd. All rights reserved.