Carcinoma of the breast in women 80 years of age and older: still a lethal disease.

Cancer of the breast is a frequent and potentially lethal problem in women 80 years of age and older. In our experience, many present with advanced disease which indicates the continuing need for patient and doctor education concerning the significance of a breast lump in the elderly. Although many of these patients have other diseases, only a small number, if thoughtfully managed, will not be fit for appropriate standard methods of treatment. In the majority of patients who died, death was due to the breast cancer and many who did die from other causes had the added misery of persisting or metastatic breast cancer. In those patients with potentially curable cancer, we recommend either wide local excision, axillary node dissection and irradiation, or modified radical mastectomy. When simple mastectomy alone is used, there is a very high local recurrence rate. Although the patients studied were treated before the era of tamoxifen therapy, it is noteworthy that hormone manipulation would be of value in many of these patients and in selected cases, chemotherapy should also be considered.