ABSTRACT
The normal ageing process brings with it changes in physiology and organ function, the accumulation of co-morbidities and progression of frailty. In this context, patient-centred decision making in breast cancer becomes more complex as these multiple factors need to be balanced to achieve best outcomes. Increasing medical complexity in older patients means they are often classified as a surgical high-risk group. The breast cancer multidisciplinary team needs to be able to effectively assess fitness in older people and recognise frailty and medical problems, particularly those that might be improved or reversed. The biology of breast cancer in older women can be shown to be clinically significantly different to younger women and associated with better prognosis. In a large series of ductal adenocarcinoma, the disease was associated with better prognosis in older women despite lower levels of the adjuvant therapy usage.
