Early breast cancer in elderly women: surgery or primary endocrine therapy?

Background Breast cancer is the most common type of cancer in women. Up to 30% of all breast cancers are reported to occur in the over 70 year age group and these percentages may increase in the near future as the mean age of the general population grows up. The standard treatment for early breast cancer in women of all ages was surgery until the late 1970s, when primary endocrine therapy was first described as an alternative to standard therapy for older women (Bradbeer 1983). Primary endocrine therapy means the use of Tamoxifen, without surgery, radiotherapy or chemotherapy. The incidence of significant co-morbidity is greater in the elderly, making general anaesthesia more hazardous.