Seminars in Oncology
Volume 31, Issue 2 , Pages 234-248 , April 2004

Breast cancer in older patients

  • Gretchen Kimmick

      Affiliations

    • Wake Forest University School of Medicine, Winston-Salem, NC, USA
    • Corresponding Author InformationAddress reprint requests to Gretchen Kimmick, MD, MS, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157 USA
  • ,
  • Hyman B Muss

      Affiliations

    • Hematology/Oncology Unit, University of Vermont, Burlington, VT, USA

References 

  1. Jemal A, Murray T, Samuels A, et al.  Cancer Statistics, 2003. CA Cancer J Clin. 2003;53:5–26
  2. Adami HO, Malker B, Holmberg L, et al.  The relation between survival and age at diagnosis in breast cancer. N Engl J Med. 1986;315:559–563
  3. Holli K, Isola J. Effect of age on the survival of breast cancer patients. Eur J Cancer. 1997;33:425–428
  4. Host H, Lund E. Age as a prognostic factor in breast cancer. Cancer. 1986;57:2217–2221
  5. Bergman L, Kluck HM, van Leeuwen FE, et al.  The influence of age on treatment choice and survival of elderly breast cancer patients in south-eastern Netherlands (A population- based study). Eur J Cancer. 1992;28A:1475–1480
  6. Yancik R, Ries LG, Yates JW. Breast cancer in aging women. A population-based study of contrasts in stage, surgery, and survival. Cancer. 1989;63:976–981
  7. Herbsman H, Feldman J, Seldera J, et al.  Survival following breast cancer surgery in the elderly. Cancer. 1981;47:2358–2363
  8. Lyman GH, Lyman S, Balducci L, et al.  Age and the risk of breast cancer recurrence. Cancer Control. 1996;3:421–427
  9. Masetti R, Antinori A, Terribile D, et al.  Breast cancer in women 70 years of age or older. J Clin Oncol. 1996;13:2722–2730
  10. Diab SG, Elledge RM, Clark GM. Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst. 2000;92:550–556
  11. Yancik R, Wesley MN, Ries LAG, et al.  Effect of age and comorbidity in postmenopausal breast cancer patients aged 55 years and older. JAMA. 2001;285:885–892
  12. Golledge J, Wiggins JE, Callam MJ. Age-related variation in the treatment and outcomes of patients with breast carcinoma. Cancer. 2000;88:369–374
  13. Goodwin JS, Samet JM, Key CR, et al.  Stage at diagnosis of cancer varies with the age of the patient. J Am Geriatr Soc. 1986;34:20–26
  14. Satariano WA, Belle SH, Swanson GM. The severity of breast cancer at diagnosis (A comparison of age and extent of disease in black and white women). Am J Public Health. 1986;76:779–782
  15. Holmes FF, Hearne E. Cancer stage-to-age relationship (Implications for cancer screening in the elderly). J Am Geriatr Soc. 1981;29:55–57
  16. American Geriatrics Society Clinical Practice Committee . AGS Position Statement (Breast cancer screening in older women). J Am Geriatr Soc. 2000;48:842–844
  17. Greenfield S, Blanco DM, Elashoff RM, et al.  Patterns of care related to age of breast cancer patients. JAMA. 1987;257:2766–2770
  18. Silliman RA, Guadagnoli E, Weitberg AB, et al.  Age as a predictor of diagnostic and initial treatment intensity in newly diagnosed breast cancer patients. J Gerontol. 1989;44:M46–M50
  19. Mohle-Boetani J. Age at breast cancer diagnosis as a predictor of subsequent survival. In:  Macieira-Coehlo A,  Nordenskjold B editor. Cancer and Aging. Boca Raton, FL: CRC Press; 1990;p. 245–254
  20. Lazovich DA, White E, Thomas DB, et al.  Underutilization of breast-conserving surgery and radiation therapy among women with stage I or II breast cancer. JAMA. 1991;266:3433–3438
  21. Repetto L, Costantini M, Campora E, et al.  A retrospective comparison of detection and treatment of breast cancer in young and elderly patients. Breast Cancer Res Treat. 1997;43:27–31
  22. Silliman RA, Balducci L, Goodwin JS, et al.  Breast cancer care in old age (What we know, don’t know, and do). J Natl Cancer Inst. 1993;85:190–199
  23. Newschaffer CJ, Penberthy L, Desch CE, et al.  The effect of age and comorbidity in the treatment of elderly women with nonmetastatic breast cancer. Arch Intern Med. 1996;156:85–90
  24. Velanovich V, Gabel M, Walker EM, et al.  Causes for the undertreatment of elderly breast cancer patients (Tailoring treatments to individual patients). J Am Coll Surg. 2002;194:8–13
  25. Bickell NA, McEvoy MD. Physicians’ reasons for failing to deliver effective breast cancer care. A framework for underuse. Med Care. 2003;41:442–446
  26. Gentili C, Sanfilippo O, Silvestrini R. Cell proliferation and its relationship to clinical features and relapse in breast cancers. Cancer. 1981;48:974–979
  27. Meyer JS, Hixon B. Advanced stage and early relapse of breast carcinomas associated with high thymidine labeling indices. Cancer Res. 1979;39:4042–4047
  28. Taylor IW, Musgrove EA, Friedlander ML, et al.  The influence of age on the DNA ploidy levels of breast-tumors. Eur J Cancer Clin Oncol. 1983;19:623–628
  29. McCarty KS, Silva JS, Cox EB, et al.  Relationship of age and menopausal status to estrogen receptor content in primary carcinoma of the breast. Ann Surg. 1983;197:123–127
  30. von Rosen A, Gardelin A, Auer G. Assessment of malignancy potential in mammary carcinoma in elderly patients. Am J Clin Oncol. 1987;10:61–64
  31. Honma N, Sakamoto G, Akiyama F, et al.  Breast carcinoma in women over the age of 85 (Distinct histological pattern and androgen, oestrogen, and progesterone receptor status). Histopathology. 2003;42:120–127
  32. Toikkanen S, Kujari H. Pure and mixed mucinous carcinomas of the breast (A clinicopathologic analysis of 61 cases with long-term follow-up). Hum Pathol. 1989;20:758–764
  33. Vicini FA, Recht A. Age at diagnosis and outcome for women with ductal carcinoma-in-situ (A critical review of the literature). J Clin Oncol. 2002;20:2736–2744
  34. Rodrigues NA, Dillon D, Carter D, et al.  Differences in the pathologic and molecular features of intraductal breast carcinoma between younger and older women. Cancer. 2003;97:1393–1403
  35. US Department of Health and Human Services . Health United States 1996–7 and Injury Chartbook. 1997; Washington, DC, DHHS Publication No. (PHS) 97–1232
  36. Satariano WA, Ragland DR. The effect of comorbidity on 3-year survival of women with primary breast cancer. Ann Intern Med. 1994;120:104–110
  37. Fish EB, Chapman JA, Link MA. Competing causes of death for primary breast cancer. Ann Surg Oncol. 1998;5:368–375
  38. Wolinsky FD, Johnson RL, Stump TE. The risk of mortality among older adults over an eight-year period. Gerontologist. 1995;35:150–161
  39. Ferrucci L, Guralnik JM, Cecchi F, et al.  Constant hierarchic patterns of physical functioning across seven populations in five countries. Gerontologist. 1998;38:286–294
  40. Bernard SL, Kincade JE, Konrad TR, et al.  Predicting mortality from community surveys of older adults (The importance of self-rated functional ability). Psychol Sci Soc Sci. 1997;52:S155–S166
  41. Dunlop DD, Hughes SL, Mannheim LM. Disability patterns in activities of daily living (Patterns of change and a hierarchy of disability). Am J Public Health. 1997;87:378–383
  42. Greiner PA, Snowdon DA, Greiner LH. The relationship of self-rated function and self-rated health to concurrent functional ability, functional decline and mortality (Findings from the Nun Study). Psychol Sci Soc Sci. 1996;51:S234–S241
  43. Satariano WA, Ragheb NE, Dupuis MA. Comorbidity in older women with breast cancer (An epidemiologic approach). In:  Yancik R,  Yates J editor. Cancer in the Elderly (Approaches to Early Detection and Treatment). New York, NY: Springer; 1989;p. 71–107
  44. Satariano WA. Comorbidity and functional status in older women with breast cancer (Implications for screening, treatment, and prognosis). J Gerontol. 1992;47:24–31
  45. Satariano WA. Aging, comorbidity, and breast cancer survival (An epidemiologic view). Adv Exp Med Biol. 1993;330:1–11
  46. Vaeth PA, Satariano WA, Ragland DR. Limiting comorbid conditions and breast cancer stage at diagnosis. J Gerontol A Biol Sci Med Sci. 2000;55:M593–M600
  47. Goodwin JS, Hunt WC, Samet JM. Determinants of cancer therapy in elderly patients. Cancer. 1993;72:594–601
  48. Turnbull AD, Gundy E, Howland WS, et al.  Surgical mortality among the elderly. An analysis of 4,050 operations (1970–1974). Clin Bull. 1978;8:139–142
  49. Singletary SE, Shallenberger R, Guinee VF. Breast cancer in the elderly. Ann Surg. 1993;218:667–671
  50. Margolese RG, Foster RS. Tamoxifen as an alternative to surgical resection for selected geriatric patients with primary breast cancer. Arch Surg. 1989;124:548–550
  51. Bradbeer JW, Kyngdon J. Primary treatment of breast cancer in elderly women with tamoxifen. Clin Oncol. 1983;9:31–34
  52. Allan SG, Rodger A, Smyth JF, et al.  Tamoxifen as primary treatment of breast cancer in elderly or frail patients (A practical management). BMJ. 1985;290:358
  53. Akhtar SS, Allan SG, Rodger A, et al.  A 10-year experience of tamoxifen as primary treatment of breast cancer in 100 elderly and frail patients. Eur J Surg Oncol. 1991;17:30–35
  54. Ciatto S, Bartoli D, Iossa A, et al.  Response of primary breast cancer to tamoxifen alone in elderly women. Tumori. 1991;77:328–330
  55. Ciatto S, Cirillo A, Confortini M, et al.  Tamoxifen as primary treatment of breast cancer in elderly patients. Neoplasma. 1996;43:43–45
  56. Bergman L, van Dongen JA, van Ooijen B, et al.  Should tamoxifen be a primary treatment choice for elderly breast cancer patients with locoregional disease?. Breast Cancer Res Treat. 1995;34:77–83
  57. Horobin JM, Preece PE, Dewar JA, et al.  Long-term follow-up of elderly patients with locoregional breast cancer treated with tamoxifen only. Br J Surg. 1991;78:213–217
  58. Preece PE, Wood RA, Mackie CR, et al.  Tamoxifen as initial sole treatment of localized breast cancer in elderly women (A pilot study). BMJ. 1982;284:869–870
  59. Gaskell DJ, Hawkins RA, de Carteret S, et al.  Indications for primary tamoxifen therapy in elderly women with breast cancer. Br J Surg. 1992;79:1317–1320
  60. VanDalsen AD, DeVries JE. Treatment of breast cancer in elderly patients. J Surg Oncol. 1995;60:80–82
  61. Robertson JF, Todd JH, Ellis IO, et al.  Comparison of mastectomy with tamoxifen for treating elderly patients with operable breast cancer. BMJ. 1988;297:511–514
  62. Gazet JC, Markopoulos C, Ford HT, et al.  Prospective randomized trial of tamoxifen versus surgery in elderly patients with breast cancer. Lancet. 1988;1:679–681
  63. Gazet JC, Ford HT, Coombes RC, et al.  Prospective randomized trial of tamoxifen vs surgery in elderly patients with breast cancer. Eur J Surg Oncol. 1994;20:207–214
  64. Bates T, Riley DL, Houghton J, et al.  Breast cancer in elderly women: A Cancer Research Campaign trial comparing treatment with tamoxifen and optimal surgery with tamoxifen alone. The Elderly Breast Cancer Working Party. Br J Surg. 1991;78:591–594
  65. Mustacchi G, Milani S, Pluchinotta A, et al.  Tamoxifen or surgery plus tamoxifen as primary treatment for elderly patients with operable breast cancer: The G.R.E.T.A. Trial. Group for Research on Endocrine Therapy in the Elderly. Anticancer Res. 1994;14:2197–2200
  66. Mustacchi G, Ceccherini R, Milani S, et al.  Tamoxifen alone versus adjuvant tamoxifen for operable breast cancer of the elderly (Long-term results of the phase III randomized controlled multicenter GRETA trial). Ann Oncol. 2003;14:414–420
  67. Maher M, Campana F, Mosseri V, et al.  Breast cancer in elderly women (A retrospective analysis of combined treatment with tamoxifen and once-weekly irradiation). Int J Radiat Oncol Biol Phys. 1995;31:783–789
  68. Clark RM, McCulloch PB, Levine MN, et al.  Randomized clinical trial to assess the effectiveness of breast irradiation following lumpectomy and axillary dissection for node- negative breast cancer. J Natl Cancer Inst. 1992;84:683–689
  69. Kantorowitz DA, Poulter CA, Sischy B, et al.  Treatment of breast cancer among elderly women with segmental mastectomy or segmental mastectomy plus postoperative radiotherapy. Int J Radiat Oncol Biol Phys. 1988;15:263–270
  70. Reed MW, Morrison JM. Wide local excision as the sole primary treatment in elderly patients with carcinoma of the breast. Br J Surg. 1989;76:898–900
  71. Veronesi U, Luini A, Del Vecchio M, et al.  Radiotherapy after breast-preserving surgery in women with localized cancer of the breast. N Engl J Med. 1993;328:1587–1591
  72. Fisher B, Redmond C, Fisher ER, et al.  Ten-year results of a randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation. N Engl J Med. 1985;312:674–681
  73. Fisher B, Jeong JH, Anderson S, et al.  Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. N Engl J Med. 2002;347:567–575
  74. Cabanes PA, Salmon RJ, Vilcoq JR, et al.  Value of axillary dissection in addition to lumpectomy and radiotherapy in early breast cancer. Lancet. 1992;339:1245–1248
  75. Mandelblatt JS, Edge SB, Meropol NJ, et al.  Sequelae of axillary lymph node dissection in older women with stage 1 and 2 breast cancer. Cancer. 2002;95:2445–2454
  76. Mandelblatt JS, Edge SB, Meropol NJ, et al.  Predictors of long-term outcomes in older breast cancer survivors (Perceptions versus patterns of care). J Clin Oncol. 2003;21:855–863
  77. McMasters KM, Tuttle TM, Carlson DJ, et al.  Sentinel lymph node biopsy for breast cancer (A suitable alternative to routine axillary dissection in multi-institutional practice when optimal technique is used). J Clin Oncol. 2000;18:2560–2566
  78. Giuliano AE, Haigh PI, Brennan MB, et al.  Prospective observational study of sentinel lymphadenectomy without further axillary dissection in patients with sentinel node-negative breast cancer. J Clin Oncol. 2000;18:2553–2559
  79. Martelli G, Moglia D, Boracchi P, et al.  Surgical resection plus tamoxifen as treatment of breast cancer in elderly patients (A retrospective study). Eur J Cancer. 1993;29A:2080–2082
  80. Martelli G, DePalo G, Rossi N, et al.  Long-term follow-up of elderly patients with operable breast cancer treated with surgery without axillary dissection plus adjuvant tamoxifen. Br J Cancer. 1995;72:1251–1255
  81. Martelli G, Miceli R, De Palo G, et al.  Is axillary lymph node dissection necessary in elderly patients with breast carcinoma who have a clinically uninvolved axilla?. Cancer. 2003;97:1156–1163
  82. Deutsch M. Radiotherpay after lumpectomy for breast cancer in very old women. Am J Clin Oncol. 2002;25:48–49
  83. Cooke AL, Perera F, Fisher B, et al.  Tamoxifen with and without radiation after partial mastectomy in patients with involved nodes. Int J Radiat Oncol Biol Phys. 1995;31:777–781
  84. Fyles A, McCready D, Manchul L, et al.  Preliminary results of a randomized study of tamoxifen +/- breast radiation in T1/2 N0 disease in women over 50 years of age. Proc Am Soc Clin Oncol. 2001;20:24a; (abstr)
  85. Hughes KS, Schnaper L, Berry D, et al.  Comparison of lumpectomy plus tamoxifen with and without radiotherpay in women 70 years of age or older who have clinical stage I, estrogen receptor positive (ER+) breast carcinoma. Proc Am Soc Clin Oncol. 2001;20:24a; (abstr)
  86. Rostom AY, Pradhan DG, White WF. Once weekly irradiation in breast cancer. Int J Radiat Oncol Biol Phys. 1987;13:551–555
  87. Kimmick GG, Muss HB. Systemic therapy for older women with breast cancer. Oncology NY. 2001;15:280–291
  88. Extermann M, Balducci L, Lyman GH. What threshold for adjuvant therapy in older breast cancer patients?. J Clin Oncol. 2000;18:1709–1717
  89. Loprinzi CL, Thome SD. Understanding the utility of adjuvant systemic therapy for primary breast cancer. J Clin Oncol. 2001;19:972–979
  90. Ravdin PM, Siminoff LA, Davis GJ, et al.  Computer program to assist in making decisions about adjuvant therapy for women with early breast cancer. J Clin Oncol. 2001;19:980–991
  91. Early Breast Cancer Trialists’ Collaborative Group . Anonymous: Tamoxifen for early breast cancer: An overview of the randomized trials. Lancet. 1998;351:1451–1467
  92. Baum M, Buzdar AU, Cuzick J, et al.  Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer (First results of the ATAC randomised trial). Lancet. 2002;359:2131–2139
  93. Early Breast Cancer Trialists’ Collaborative Group . Anonymous: Polychemotherapy for early breast cancer: An overview of the randomized trials. Lancet. 1998;352:930–942
  94. Von Hoff DD, Layard MW, Basa P, et al.  Risk factors for doxorubicin-induced congestive heart failure. Ann Intern Med. 1979;91:710–717
  95. Aapro MS. Adjuvant therapy of primary breast cancer (a review of key findings from the 7th international conference, St Gallen, February 2001). Oncologist. 2001;6:376–385
  96. Du X, Goodwin JS. Increase of chemotherapy use in older women with breast carcinoma from 1991 to 1996. Cancer. 2001;92:730–737
  97. Colleoni M, Price KN, Castiglione-Gertsch M, et al.  Mortality during adjuvant treatment of early breast cancer with cyclophosphamide, methotrexate, and fluorouracil. Lancet. 1999;354:130–131
  98. Crivellari D, Bonetti M, Castiglione-Gertsch M, et al.  Burdens and benefits of adjuvant cyclophosphamide, methotrexate, and fluorouracil and tamoxifen for elderly patients with breast cancer (The International Breast Cancer Study Groups Trial VII). J Clin Oncol. 2000;18:1412–1422
  99. Fisher B, Redmond C, Legault-Poisson S, et al.  Postoperative chemotherapy and tamoxifen compared with tamoxifen alone in the treatment of positive-node breast cancer patients aged 50 years and older with tumors responsive to tamoxifen (Results from the National Surgical Adjuvant Breast and Bowel Project B-16). J Clin Oncol. 1990;8:1005–1018
  100. Fisher B, Brown AM, Dimitrov NV, et al.  Two months of doxorubicin-cyclophosphamide with and without interval reinduction therapy compared with 6 months of cyclophosphamide, methotrexate, and fluorouracil in positive-node breast cancer patients with tamoxifen-nonresponsive tumors (Results from the National Surgical Adjuvant Breast and Bowel Project B-15). J Clin Oncol. 1990;8:1483–1496
  101. Wils JA, Bliss JM, Marty M, et al.  Epirubicin plus tamoxifen versus tamoxifen alone in node-positive postmenopausal patients with breast cancer (A randomized trial of the International Collaborative Cancer Group). J Clin Oncol. 1999;17:1988–1998
  102. Ellis MJ, Hayes DF, Lippman ME. Treatment of metastatic breast cancer. In:  Harris JR,  Lippman ME,  Morrow M editor. Diseases of the Breast. Philadelphia, PA: Lippincott Williams & Wilkins; 2000;p. 749–797
  103. Bonneterre J, Buzdar A, Nabholtz JM, et al.  Anastrozole is superior to tamoxifen as first-line therapy in hormone receptor positive advanced breast carcinoma. Cancer. 2001;92:2247–2258
  104. Mouridsen H, Gershanovich M, Sun Y, et al.  Superior efficacy of letrozole versus tamoxifen as first-line therapy for postmenopausal women with advanced breast cancer (Results of a phase III study of the international letrozole breast cancer group). J Clin Oncol. 2001;19:2596–2606
  105. Jones S, Vogel C, Arkhipov A, et al.  Multicenter, phase II trial of exemestane as third-line hormonal therapy of postmenopausal women with metastatic breast cancer. Aromasin Study Group. J Clin Oncol. 1999;17:3418–3425
  106. Kaufmann M, Bajetta E, Dirix LY, et al.  Exemestane improves survival compared with megoestrol acetate in postmenopausal patients with advanced breast cancer who have failed on tamoxifen (Results of a double-blind randomised phase III trial). Eur J Cancer. 2000;36:S86–S87
  107. Osborne CK, Pippen J, Jones SE, et al.  Double-blind, randomized trial comparing the efficacy and tolerability of fulvestrant versus anastrozole in postmenopausal women with advanced breast cancer progressing on prior endocrine therapy (Results of a North American trial). J Clin Oncol. 2002;20:3386–3395
  108. Carlson RW. Sequencing of endocrine therapies in breast cancer-Integration of recent data. Breast Cancer Res Treat. 2002;75:S27–S32
  109. Taylor SG, Gelman RS, Falkson G, et al.  Combination chemotherapy compared to tamoxifen as initial therapy for stage IV breast cancer in elderly women. Ann Intern Med. 1986;104:455–461
  110. The Australian and New Zealand Breast Cancer Trials Group Clinical Oncological Society of Australia . Anonymous (A randomized trial in postmenopausal patients with advanced breast cancer comparing endocrine and cytotoxic therapy given sequentially or in combination). J Clin Oncol. 1986;4:186–193
  111. Begg CB, Elson PJ, Carbone PP. A study of excess hematologic toxicity in elderly patients treated on chemotherapy protocols. In:  Yancik R editors. Cancer in the Elderly (Approaches to Early Detection and Management). New York, NY: Springer-Verlag; 1989;p. 149–161
  112. Gelman RS, Taylor SG. Cyclophosphamide, methotrexate, and 5-fluorouracil chemotherapy in women more than 65 years old with advanced breast cancer (The elimination of age trends in toxicity by using doses based on creatinine clearance). J Clin Oncol. 1984;2:1404–1413
  113. Christman K, Muss HB, Case LD, et al.  Chemotherapy of metastatic breast cancer in the elderly. The Piedmont Oncology Association experience. JAMA. 1992;268:57–62
  114. Ibrahim NK, Frye DK, Buzdar AU, et al.  Doxorubicin-based chemotherapy in elderly patients with metastatic breast cancer. Tolerance and outcome. Arch Intern Med. 1996;156:882–888
  115. Giovanazzi-Bannon S, Rademaker A, Lai G, et al.  Treatment tolerance of elderly cancer patients entered onto phase II clinical trials (An Illinois Cancer Center study). J Clin Oncol. 1994;12:2447–2452
  116. Ibrahim NK, Hortobagyi GN, Ewer M, et al.  Doxorubicin-induced congestive heart failure in elderly patients with metastatic breast cancer, with long-term follow-up (The M.D. Anderson experience). Cancer Chemother Pharmacol. 1999;43:471–478
  117. Du XL, Oxborne C, Goodwin JS. Population-based assessment of hospitalizations for toxicity from chemotherapy in older women with breast cancer. J Clin Oncol. 2002;20:4636–4642
  118. Ravdin PM, Valero V. Review of docetaxel (Taxotere), a highly active new agent for the treatment of metastatic breast cancer. Semin Oncol. 1995;22(suppl 4):17–21
  119. Hortobagyi GN, Holmes FA. Single-agent paclitaxel for the treatment of breast cancer (An overview). Semin Oncol. 1996;23(suppl 1):4–9
  120. Perez EA, Vogel CL, Irwin DH, et al.  Weekly paclitaxel in women age 65 and above with metastatic breast cancer. Breast Cancer Res Treat. 2002;73:85–88
  121. Sorio R, Robieux I, Galligioni E, et al.  Pharmacokinetics and tolerance of vinorelbine in elderly patients with metastatic breast cancer. Eur J Cancer. 1997;33:301–303
  122. Vogel C, O’Rourke M, Winer E, et al.  Vinorelbine as first-line chemotherapy for advanced breast cancer in women 60 years of age or older. Ann Oncol. 1999;10:397–402
  123. Ranson MR, Carmichael J, O’Byrne K, et al.  Treatment of advanced breast cancer with sterically stabilized liposomal doxorubicin (Results of a multicenter phase II trial). J Clin Oncol. 1997;15:3185–3191
  124. Blum JL, Buzdar AU, LoRusso PM, et al.  A multicenter phase II trial of Xeloda (capecitabine) in paclitaxel-refractory metastatic breast cancer. Proc Am Soc Clin Oncol. 1998;17:125a; (abstr)
  125. Seidman A, Hudis C, Pierri MK, et al.  Cardiac dysfunction in the trastuzumab clinical trials experience. J Clin Oncol. 2002;20:1215–1221
  126. Cobleigh MA, Vogel CL, Tripathy D, et al.  Efficacy and safety of HerceptinTM (humanized anti-HER2 antibody) as a single agent in 222 women with HER2 overexpression who relapsed following chemotherpay for metastatic breast cancer. Proc Am Soc Clin Oncol. 1998;17:97a; (abstr)
  127. Vogel C, Cobleigh M, Tripathy D, et al.  First-line, non-hormonal, treatment of women with HER2 overexpressing metastatic breast cancer with Herceptin (trastuzumab, humanized anti-HER2 antibody). Proc Am Soc Clin Oncol. 2000;19:71a; (abstr)
  128. Seidman AD, Fornier MN, Esteva FJ, et al.  Weekly trastuzumab and paclitaxel therapy for metastatic breast cancer with analysis of efficacy by HER2 immunophenotype and gene amplification. J Clin Oncol. 2001;19:2587–2595
  129. Burstein HJ, Kuter I, Campos SM, et al.  Clinical activity of trastuzumab and vinorelbine in women with HER2-overexpressing metastatic breast cancer. J Clin Oncol. 2001;19:2722–2730
  130. Hillner BE, Ingle JN, Berenson JR, et al.  American Society of Clinical Oncology guideline on the role of bisphosphonates in breast cancer. American Society of Clinical Oncology Bisphosphonates Expert Panel. J Clin Oncol. 2000;18:1378–1391
  131. Del Mastro L, Venturini M, Lionetto R, et al.  Randomized phase III trial evaluating the role of erythropoietin in the prevention of chemotherapy-induced anemia. J Clin Oncol. 1997;15:2715–2721
  132. Trimble EL, Carter CL, Cain D, et al.  Representation of older patients in cancer treatment trials. Cancer. 1994;74:2208–2214
  133. Hutchins LF, Unger JM, Crowley JJ, et al.  Underrepresentation of patients 65 years of age or older in cancer-treatment trials. N Engl J Med. 1999;341:2061–2067

PII: S0093-7754(03)00671-7

doi: 10.1053/j.seminoncol.2003.12.033

Seminars in Oncology
Volume 31, Issue 2 , Pages 234-248 , April 2004