EDISCIENCES

ABSTRACT

Although breast cancer is generally considered to be indolent in the elderly, there is certain variability in its characteristics and clinical outcomes in the oldest population. Indeed, a substantial proportion of older women have a diagnosis of triple-negative breast cancer (TNBC), a subtype with usually poor prognosis. TNBC in the elderly represents a substantial treatment challenge: geriatric assessment and life expectancy evaluation are mandatory. Local treatments, such as surgery and radiation, and adjuvant chemotherapy play a central role in early stage TNBC whereas chemotherapy remains the cornerstone of the systemic treatment of metastatic TNBC. However, few randomized controlled trials have been conducted to evaluate the effectiveness of breast cancer treatments on women aged 70 or older. Hence, the less aggressive treatment strategies, usually chosen to respect patients’ frailty and vulnerability, are mostly empirical and not evidence-based. As a consequence, the impact of potential undertreatment on cancer recurrence and overall survival is not known. The identification of new strategies is therefore urgently needed to guarantee the best therapeutic chances to elderly patients with TNBC without exposing them to unacceptable and dangerous toxicities.