Mammakarzinom bei älteren Patientinnen – Altersgerechte adjuvante systemische Therapie

Aufgrund mangelnder Evidenz existiert für > 65-jährige Brustkrebspatientinnen keine Standardtherapie, und die Therapieempfehlungen basieren v.a. auf der Datenlage jüngerer postmenopausaler Patientinnen. Es besteht für alle Therapiemodalitäten eine Fehlversorgung, die einen negativen Effekt auf das rezidivfreie Überleben und das Gesamtüberleben hat. Alter an sich sollte kein Faktor sein, der die Therapiewahl bestimmt, sondern der erwartete individuelle Nutzen einer Therapie sollte mit ihren Risiken unter Berücksichtigung der Komorbiditäten und der weiteren Lebenserwartung abgewogen werden. Bei nach geriatrischem Assessment als ”fit“ eingestuften älteren Patientinnen sollte eine Therapie gemäß den aktuellen Leitlinien gewählt werden. Eine adjuvante Chemotherapie sollte insbesondere bei Hormonrezeptor-negativen Karzinomen häufiger eingesetzt werden. Eine endokrine Therapie sollte allen Hormonrezeptor-positiven Patientinnen angeboten werden.

Due to a lack of evidence, there are no standard therapies for female patients over 65 years of age with breast cancer and therapy recommendations are based, above all, on data from younger post-menopausal women. For all therapeutic modalities there is a supply deficit that has a negative effect on recurrence-free survival and total survival. For elderly patients classified geriatrically as fit, a therapy in accord with the current guidelines should be chosen. In particular, adjuvant chemotherapy should be employed more frequently, especially for hormone receptor-negative carcinomas. All hormone receptor-positive patients should be offered endocrine treatment.

Key words

breast cancer - elderly female patients - chemotherapy - endocrine treatment

• Literatur

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