EDISCIENCES

ABSTRACT

Breast cancer is the most common tumor in women and the sec- ond most common cancer death, approximately more than 30% of patients are diagnosed over 70 years. The chronologic age should not be the only determinant in treatment of older patients, there- fore a tailored therapies are required. The management therapeutic should be guided by individual life expectancy, performance status, social status and chronologic age. Radiotherapy reduces the incidence of local recurrence, about 8-10% respect to non-irradiated pts in which the local recurrence is 25-35% independently of other associated factors.11 It is not al- ways indicate for older patients a conventional fractionation with daily radiotherapy. Older patients with cardiac comorbidities have higher failure hearth risks with radiotherapy.14 Advances in treat- ment planning with improved irradiation at target volumes and mim- imal exposition to OARs, especially to heart, placed the emphasis on discomfort of the daily treatment and to allowed development of weekly radiotherapic schedule. In literature was de ned the hypof- ractionation as treatment safe, feasibility, and increased comfort, especially in older and or frail patients.15 Guidelines-according mas- tectomy is, often, performed in low risk breast cancer in women who cannot perform adjuvant radiotherapy either due to comorbidity or poor compliance. In 2011 Early Breast Cancer Trialists’ Collaborative Group de ned the bene ts of radiotherapy related to PS patients and status dis- ease.11 Jeffrey M et al observed no advantage in OS e RL in mas- tectomy vs BCS with radiationtherapy in patients with age 75-79 years.23 Radiosensibility may differ according to breast cancer subtype. We need for further genomic studies to identify patients who could not bene t from adjuvant locoregional treatment. Actually the possible omission of RT must be delegated to a multidisciplinary team with respect to the guidelines, considering new standard schedule radio- therapy, as hypofractionation. Comorbidities, socioeconomic status and prognostic factors carefully must evaluated in omission radio- therapy.