Treatment of older patients with breast cancer : improving the evidence

Glas, N.A. de (2015)

Doctoral Thesis

Currently, 35-45% of newly diagnosed breast cancer patients in developed countries is aged 65 years and older. Older women with breast cancer comprise a heterogeneous group due to large differences with regard to concomitant diseases, physiological reserve and functional status. Current guidelines for breast cancer are based on studies that were mostly performed in younger patients. Therefore, treatment of older women with breast cancer is not evidence-based, and it cannot be expected that clinical trials will fill this gap of knowledge in the near future. The aim of this thesis was to investigate several aspects of breast cancer treatment in older women. In Part I, several aspects of treatment in older breast cancer patients were assessed. Part II assessed methodological aspects of studying breast cancer in older patients. This thesis has shown that older patients are at increased risk for overdiagnosis of breast cancer due to population screening, with potential harmful effects due to the increased risk of complications of treatment. Despite changing treatment strategies, breast cancer prognosis of older women has not improved. Current treatment strategies and decisions tools are insufficient. Observational studies will become increasingly important in this patient population, the use of accurate methods will be essential.

• Epidemiology
• Oncology
• Geriatric oncology
• Older patients
• Breast cancer

• All authors: Glas, N.A. de
• Supervisor: Velde, C.J.H. van de
• Co-supervisor: Liefers, G.J.; Portielje, J.E.A.
• Qualification: Doctor (dr.)
• Awarding Institution: Leiden University Medical Center (LUMC), Leiden University
• Date: 2015-04-15
• ISBN (print): 9789461089083
• Sponsorship: KWF Kankerbestrijding, STichting ALpe d'HuZes