Radiation therapy for the elderly—change of concepts in breast cancer?

Increasing aging in cancer patients is a relevant and important issue and problem in the decision-making process in oncology. A rising number of patients with malignant disease is expected including breast cancer which stays as the most common cancer in women worldwide with over 2 million new cases in 2018 (1). With the continuous improvement of diagnostic methods and the widespread implementation of more efficacious screening processes most breast cancers can be detected much earlier than in previous decades. However, so far most current guidelines make no difference in the therapy strategy for women of advance age beyond 70–80 years or even older. Generally, the decision-making process involving older patients is complicated and remains often as a task for the physician rather than a fully established tumor board. The goal of this review is to outline the most important factors that could be relevant in the decision making for radiotherapy for elderly woman affected by invasive breast cancer