hormonothérapie; chirurgie; radiothérapie; cancer du sein; patient âgé; chimiothérapie
Abstract :
[fr] Le cancer du sein représente chez la personne âgée une pathologie fréquente. Le choix du traitement dépend de l'âge physiologique, des pathologies et comorbidités associées ainsi que du niveau de vie et d'autonomie. De plus, selon les facteurs histopronostiques (récepteurs aux oestrogènes et à la progestérone, la surexpression du cerb-B2) on décidera éventuellement du schéma thérapeutique le plus approprié. Chez la personne âgée, la chirurgie (mastectomie ou tumorectomie), la radiothérapie et l'hormonothérapie trouvent leur place. Au-delà de 70 ans, la place de la chimiothérapie est incertaine. En effet, les patientes de plus de 70 ans sont sous-représentées dans les études randomisées.
Disciplines :
Oncology
Author, co-author :
Gillain, Sophie ; Centre Hospitalier Universitaire de Liège - CHU > Gériatrie
Gennigens, Christine ; Centre Hospitalier Universitaire de Liège - CHU > Oncologie médicale
Sautois, Brieuc ; Centre Hospitalier Universitaire de Liège - CHU > Oncologie médicale
Polus, Marc ; Centre Hospitalier Universitaire de Liège - CHU > Gastro-Entérologie-Hépatologie
Bonnet, Christophe ; Université de Liège - ULiège > Département des sciences cliniques > Hématologie - Oncologie médicale
Fillet, Georges ; Université de Liège - ULiège > Département des sciences cliniques > Hématologie - Oncologie médicale
Jerusalem, Guy ; Centre Hospitalier Universitaire de Liège - CHU > Oncologie médicale
Language :
French
Title :
Traitement du cancer du sein chez la personne âgée
Pignon T, Rafaramino F, Scalliet P. Cancer et sujets âgés. Prise en charge. Aspects décisionnels. Rev Méd Interne 2000; 21: 765-76.
Wyld L, Reed MWR. The need for targeted research into breast cancer in the elderly. Br J Surgery 2003; 90: 388-99.
Diab SG, Eliedge RM, Clark GM. Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst 2000; 92: 550-6.
Berg JW, Hutter RVP. Breast cancer. Cancer 1995; 75: 257-69.
Ries LAG, Eisner MP, Kosary CL. SEER Cancer Statistics Review 1973-1999 National Cancer Institute, Bethesda MD, Available at: http://seer.cancer.gov/ csr/1973-1999/ Accessed August 25, 2002.
Monfardini S, Ferrucci L, Fratino L, Del Lungo I, Serraino D, Zagonel V. Validation of a multidimensional evaluation scale for use in elderly cancer patients. Cancer 1996; 77: 395-401.
Fentiman IS, Christiaens MR, Paridaehs R. et al. Treatment of operable breast cancer in the elderly: A randomised clinical trial EORTC 10851 comparing tamoxifen alone with modified radical mastectomy. Eur J Cancer 2003; 39: 309-16.
Mustacchi G, Ceccherini R, Milani A, Pluchinotta A, De Matteis A, Maiorino L. Tamoxifen alone versus adjuvant tamoxifen for operable breast cancer of elderly: Long-term results of the phase III randomized controlled multicenter GRETA trial. Ann Oncol 2003; 14: 414-20.
Fentiman IS, van Zijl J, Karydas I, et al. Treatment of operable breast cancer in the elderly: A randomised clinical trial EORTC 10850 comparing modified radical mastectomy with tumorectomy plus tamoxifen. Eur J Cancer 2003; 39: 3003.
Goldhirsch A, Glick JH, Gelber RD, Coates AS, Senn HJI. Meeting Highlights: International concensus panel on the treatment of primary breast cancer. Seventh international conference on adjuvant therapy of primary breast cancer. J Clin Oncol 2001; 19: 3317-27.
Early Breast Cancer Trialists' Collaborative Group. Favourable and unfavourable effects on long-term survival of radiotherapy for elderly breast cancer: An overview of the randomised trials. Lancet 2000; 355: 1757-70.
Holli K, Valavaara R, Blanco G, Kataja V, Hietanen P, Flander M. Safety and efficacy results of a randomized trial comparing adjuvant toremifene and tamoxifen in postmenopausal patients with node positive breast cancer. Finnish Breast Cancer Group. J Clin Oncol 2000; 18: 3487-94.
Wyckooff J, Greenberg H, Sanderson R, Wallach P, Balducci L. Breast irradiation in the older woman: A toxicity study. J Am Geriatr Soc 1994; 42: 150-2.
Deutsch M. Radiotherapy after lumpectomy for breast cancer in very old women. Am J Clin Oncol 2002; 25: 48-9.
Wasil T, Lichtman SM, Gupta V, Rush S. Radiation therapy in cancer patients 80 years of age and older. Am J Clin Oncol 2000; 23: 526-30.
Zachariah B, Balducci L, Venkattaramanabalaji GV, Casey L, Grennberg HM, DelRegato JA. Radiotherapy for cancer patients age 80 and older: A study of effectiveness and side effects. Int J Radiat Oncol Biol Phys 1997; 39: 1125-9.
Shapiro CL, Recht A. Side effects of adjuvant treatment of breast cancer. N Engl J Med 2001; 344: 1997-2008.
The ATAC (Arimidex Tamoxifene Alone or in Combination) Trialists' Group. Anastrazol alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women wirth early breast cancer: First results of the ATAC randomised trial. Lancet 2002; 359: 2131-9.
Goss PE, Ingle JN, Martino S, Robert NJ, Muss HB, Piccart MJ. A randomised trial of letrozole in postmenopausal women after five years of tamoxifen therapy for early-stage breast cancer. N Engl J Med 2003; 349: 1793-802.
Coombes RC, Hall E, Gibson LI, Paridaens R, Jassem J, Delozier T. A randomised trial of exemestane after two to three years of tamoxifen therapy in postmemopausal women with primary breast cancer. N Engl J Med 2004; 350: 1081-92.