Purpose: Although elderly cancer patients have a higher risk for developing the disease they
may not receive optimal oncological care. This may be due to factors such as comorbidities,
limited compliance with clinical guidelines and insufficient evidence for guideline
recommendations for this age group. The evidence for the benefit of chemotherapy in
the population of elderly women with breast cancer was examined in the present review.
Methods: A systematic review of relevant literature in English identifying studies published
from January 2000 to April 2023 was conducted. The analysis included studies on application
of chemotherapy and its effects on survival and toxicities. We searched PubMed databases
for relevant publications. In total, 24 studies were included in the present review.
Results: The benefit of chemotherapy in elderly patients was variable. This review suggests
that there is insufficient evidence to avoid chemotherapy in healthy elderly patients
with high-risk breast cancer (BC) or specific subtypes such as triple negative or
HER2-positive BC. While some studies suggest that older patients may have less aggressive
tumor biology, data regarding pathological complete response (pCR) rates or surgical
downstaging rates after neoadjuvant chemotherapy (NACT) between different age groups
remains controversial.
Conclusion: Data on effects of chemotherapy in elderly patients seemed too heterogeneous to draw
valid conclusions due to heterogeneity in the definition of “elderly” patients, the
application of different substances and different dosages. Patients with high risk
breast cancer may have a benefit from chemotherapy.
Keywords: elderly patients·adjuvant chemotherapy·neoadjuvant chemotherapy·breast cancer
