Updated recommendations regarding the management of older patients with breast cancer: a joint paper from the European Society of Breast Cancer Specialists (EUSOMA) and the International Society of Geriatric Oncology (SIOG)

Laura Biganzoli, Nicolò Matteo Luca Battisti, Hans Wildiers, Amelia McCartney, Giuseppe Colloca, Ian H. Kunkler, Maria João Cardoso, Kwok Leung Cheung, Nienke Aafke de Glas, Rubina M. Trimboli, Beatriz Korc-Grodzicki, Enrique Soto-Perez-de-Celis, Antonio Ponti, Janice Tsang, Lorenza Marotti, Karen Benn, Matti S. Aapro, Etienne G.C. Brain

Research output: Contribution to journalReview ArticleResearchpeer-review

121 Citations (Scopus)


Breast cancer is increasingly prevalent in older adults and is a substantial part of routine oncology practice. However, management of breast cancer in this population is challenging because the disease is highly heterogeneous and there is insufficient evidence specific to older adults. Decision making should not be driven by age alone but should involve geriatric assessments plus careful consideration of life expectancy, competing risks of mortality, and patient preferences. A multidisciplinary taskforce, including members of the European Society of Breast Cancer Specialists and International Society of Geriatric Oncology, gathered to expand and update the previous 2012 evidence-based recommendations for the management of breast cancer in older individuals with the endorsement of the European Cancer Organisation. These guidelines were expanded to include chemotherapy toxicity prediction calculators, cultural and social considerations, surveillance imaging, genetic screening, gene expression profiles, neoadjuvant systemic treatment options, bone-modifying drugs, targeted therapies, and supportive care. Recommendations on geriatric assessment, ductal carcinoma in situ, screening, primary endocrine therapy, surgery, radiotherapy, adjuvant systemic therapy, and secondary breast cancer were updated.

Original languageEnglish
Pages (from-to)e327-e340
Number of pages14
JournalThe Lancet Oncology
Issue number7
Publication statusPublished - Jul 2021
Externally publishedYes

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