«Клинико-морфологические особенности лечения операбельного рака молочной железы у пожилых (>65) лет женщин» (стр. 13 )

Практические рекомендации

Выявляемость РМЖ у пожилых напрямую зависит от коморбидности, снижении функциональной активности больных, а так же отсутствие онкологической настороженности врачей общей лечебной сети и, как следствие, неполное клиническое и инструментальное (маммография, УЗИ, биопсия). Клиницисты должны ответственно подходить к осмотру и обследованию молочных желез в любых возрастных категориях. В сомнительных случаях пожилой возраст не должен является противопоказанием к выполнению любого вида биопсии (пункционное + цитологическое исследование, трепан-биопсия, при необходимости эксцизионная биопсия с гистологическим и иммуногистохимическим исследованием (ИГХ), определяющие последующую стратегию и тактику лечения этих больных).

Для течения РМЖ в пожилом возрасте характерен низкий уровень толерантности организма к цитостатикам. В следствии адекватная оценка общего состояния способствует выработке оптимальной лечебной тактики с учетом индивидуальных особенностей пожилого больного. Выбор оптимальных лечебных режимов, адаптация доз вводимых препаратов в соответствии с физиологическими особенностями организма, использование всего арсенала средств сопроводительной терапии является залогом эффективности и безопасности лечения РМЖ.

  Выбор лечебной тактики у пожилых должен основываться не на хронологическом, а на биологическом возрасте, более точно отражающем индивидуальные особенности пациента.

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