Therapeutic Management in Elderly Male Breast Cancer Patients: A Scoping Review.

IF 4.7 2区 医学 Q1 ONCOLOGY
Alessia Di Rito, Antonietta Grillo, Roberta Carbonara
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引用次数: 0

Abstract

Purpose of review: Male breast cancer (MBC) is a rare entity which often arises in elderly people. Aim of this review is to evaluate the principal issues related to MBC in elderly, because the therapeutic management of disease is not only related to the biological behavior of the tumor, but also to the comorbidities and frailty of older population. A scoping literature review was performed on Pubmed and Cochrane Database using the following keywords: therapeutic management/ male/ breast cancer/ elderly patients. Papers published before 2000, not edited in English or French language, or not related to the main topic, were excluded. Only articles related to therapeutic issues in MBC and including more than 10 elderly (≥ 65 years) patients were selected for the qualitative outcome analysis.

Recent findings: 36 papers regarding surgery, radiotherapy, systemic therapy, racial disparities and therapeutic management in retrospective series of MBC in elderly were examined in details. MBC has a different biological behavior and a poorer prognosis than female, especially in cases with positive nodes at diagnosis. Elderly MBC patients have often larger tumors in more advanced stages at the time of diagnosis compared with younger patients. In spite of the advanced tumors at presentation, older patients present often cancers with more favorable biological characteristics, but they receive less guideline-concordant curative treatments (as adequate lymph node staging or adjuvant radiation therapy) compared to women. Moreover, racial differences in treatment of older MBC were observed. Therapeutic management of MBC in elderly patients is a subject rarely addressed in literature. Our review highlighted differences in the treatment and in guidelines-concordance for elderly MBC patients. Adequate geriatric assessment and use of therapeutic schemes adapted to age and comorbidities can avoid under/overtreatment, contributing to a better standard of care in this frail population.

老年男性乳腺癌患者的治疗管理:范围综述。
回顾目的:男性乳腺癌(MBC)是一种罕见的疾病,常见于老年人。本文综述的目的是评价与老年MBC相关的主要问题,因为疾病的治疗管理不仅与肿瘤的生物学行为有关,而且与老年人群的合并症和脆弱性有关。在Pubmed和Cochrane数据库中检索相关文献,关键词:治疗管理/男性/乳腺癌/老年患者。2000年以前发表的论文,非英语或法语编辑的,或与主要主题无关的,被排除在外。仅选择与MBC治疗问题相关的文章并纳入10例以上老年(≥65岁)患者进行定性结局分析。回顾性分析了36篇关于老年MBC的手术、放疗、全身治疗、种族差异和治疗管理的文献。与女性相比,MBC具有不同的生物学行为和较差的预后,特别是在诊断时淋巴结阳性的病例中。与年轻患者相比,老年MBC患者在诊断时往往在更晚期有更大的肿瘤。尽管在发病时肿瘤已经发展到晚期,但与女性相比,老年患者通常表现出更有利的生物学特征,但他们接受的治疗较少符合指南(如适当的淋巴结分期或辅助放射治疗)。此外,老年MBC的治疗也存在种族差异。老年MBC患者的治疗管理是文献中很少涉及的课题。我们的综述强调了老年MBC患者在治疗和指南一致性方面的差异。充分的老年评估和使用适合年龄和合并症的治疗方案可以避免治疗不足/过度,有助于提高这一虚弱人群的护理标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.50
自引率
0.00%
发文量
187
审稿时长
6-12 weeks
期刊介绍: This journal aims to review the most important, recently published clinical findings in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by cancer. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as cancer prevention, leukemia, melanoma, neuro-oncology, and palliative medicine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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