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Recommendation
Primary endocrine therapy without surgery in older patients
Primary endocrine therapy (endocrine therapy alone without surgery) should only be offered to older patients with ER-positive tumours who have a short-estimated life expectancy (<2–3 years), who are considered unfit for surgery after optimisation of comorbid medical conditions, or who decline surgery. The involvement of a geriatrician is strongly recommended to estimate life expectancy and guide management of reversible comorbidities. It is reasonable to choose tamoxifen, or an aromatase inhibitor based on potential side-effects.
Primary endocrine therapy should only be offered to elderly individuals with ER-positive tumours who have a short-estimated life expectancy (<2–3 years), who are considered unfit for surgery after optimisation of medical conditions or who refuse surgery. The involvement of a geriatrician is strongly recommended to estimate life expectancy and guide management of reversible comorbidities. It is reasonable to choose tamoxifen, or an aromatase inhibitor based on potential side-effects
How this guidance was developed
This recommendation was adopted from the SIOG/EUSOMA 2012 guidelines on the management of elderly patients with breast cancer (Europe). The source recommendation was based on a systematic review of the evidence conducted to June 2010 and was not graded by the source guideline authors. The source recommendation was accepted with minor stylistic changes, but with no changes to the meaning or tone of the source recommendation.
Related guidance by topic
Primary endocrine therapy without surgery in older patients
Recommendation
Primary endocrine therapy (endocrine therapy alone without surgery) should only be offered to older patients with ER-positive tumours who have a short-estimated life expectancy (<2–3 years), who are considered unfit for surgery after optimisation of comorbid medical conditions, or who decline surgery. The involvement of a geriatrician is strongly recommended to estimate life expectancy and guide management of reversible comorbidities. It is reasonable to choose tamoxifen, or an aromatase inhibitor based on potential side-effects.
Principles in action
Patient-centred care
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Safe and quality care
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Multidisciplinary care
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Communication
This recommendation was adopted from the SIOG/EUSOMA 2012 guidelines on the management of elderly patients with breast cancer (Europe). The source recommendation was based on a systematic review of the evidence conducted to June 2010 and was not graded by the source guideline authors. The source recommendation was accepted with minor stylistic changes, but with no changes to the meaning or tone of the source recommendation.
Related guidance by topic
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