ABSTRACT
The foremost cancer diagnosis and the second leading cause of cancer-related death in American women, breast cancer, is becoming a ‘‘common disease’’ and is greatly feared. In 1997, the American Cancer Society estimated that there would be 181,600 new cases and 44,190 deaths due to breast cancer (1). Despite the great research effort to decrease the impact of this disease, few major advances have been made. The thrust of efforts must now be directed at prevention and early detection. In the geriatric population, this is no less of an issue. An estimated 48% of women diagnosed with metastatic breast cancer and 52% of all breast cancer deaths are in women greater than 65 years of age (2). In fact, breast cancer incidence and mortality rates increase with age (3, 4). In the SEER (Surveillance, Epidemiology, and End Results) Program database, breast cancer occurs in 60 per 100,000 women age less than 65 years old; 322 per 100,000 women aged over 65 years; and 375 per 100,000 women over 85 years old (2). Breast cancer-related mortality rates reach 172 women per 100,000 women over the age of 85 years as compared to 18 per 100,000 and 80 per 100,000 women aged 35-44 and 55-64 years, respectively (Fig. 1) (2). The size of the geriatric population is also growing. Since 1900, the population over the age of 65 years has increased 10-fold. Today, approximately 30 million Americans, or 1 in 9, are over 65 years old compared to only 1 in 15 persons in 1940. It is projected that in 2020, one in five Americans will be over 65 years old. Presently, almost half of all newly diagnosed breast cancers in the United States occur in women over age 65 years (2, 5), and it is estimated that, by 2030, two thirds of patients with breast cancer will be 65 years old or older (6).
