treatment in elderly

My Aunt is 74 yrs. old has just been diagnosed with a malignant tumor in the areola region of her breast. She has aa pace maker defibrlator unit and is in frail health overall.  What in your opinion would be the best course of treatment?  I have read that tamoxifin (tamoxifen) is sometin-mes used to avoid surgery. Is this a good option? I have read confilicting research and am now confused.  Thank you J.Abbott

[CCF-RN,MSN-rf]

Dear JAbbott:  There is no clear answer here.  In general, breast cancer is a surgical disease.  Using tamoxifen would only be beneficial if the tumor is estrogen receptor positive.  It would not be a replacement for surgery - it would be considered palliative (relieve symptoms without the goal of cure).  On the other hand, if her health is that frail, this may or may not be an option.  The doctors would have to evaluate the use of any procedure or medication with respect to her heart issues.  These situations should be evaluated on a case by case basis - considering her health, prognosis,the abilities of those caring for her, and the potential risks versus benefits.