For an early stage, estrogen receptor positive breast cancer in an elderly patient, would you recommend: hormonal therapy alone, radiation alone or both?  

Based on the CALGB (and PRIME II, shorter follow up) data hormonal therapy without RT is a reasonable choice for many older patients given that there is no survival advantage to the addition of RT. Some patients who are in excellent health and want the maximum risk reduction, may be candidates for a...

PRIME, CALGB, Austrian, Canadian studies have all looked at antiestrogen with and without RT. I think in this subset of elderly luminal A pts we need study looking at AI vs. short course RT with endpoints being efficacy, QOL, compliance and cost of care to quantify which is better approach

I think it is time to re-evaluate the concept of treatment de-intensification with endocrine therapy alone due to the toxicities, and compliance associated with endocrine therapy. More and more patients do not wish to pursue endocrine therapy and I will routinely offer hypofractionated WBI or APBI f...

When elderly females are given the choice between-- Going an an aromatase inhibitor with the accompanying arthralgias, bone density loss (requiring yearly bone density scans and starting bisphosphonate therapy if osteoporosis is found--with its accompanying side effects), the need to get yearly p...