Breast cancer and aging.

While many of the basic principles of breast cancer management are the same for younger and older women, a number of breast cancer issues particularly important for elderly women have not been resolved. Many of these management questions need answers based on data that are better than that currently available. At what age should the clinician consider cessation of screening mammography? For which very elderly patients might tamoxifen alone be adequate treatment for primary operable breast cancer? How can we develop better guidelines for the selection and administration of cytotoxic chemotherapy in an elderly population? What is the appropriate systemic adjuvant therapy, if any, for the patient over the age of 70? These and other questions may be answered through the development of clinical trials directed specifically at the elderly population.