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Breast cancer represents 40% of all carcinomas and is responsible for the 20% of deads due to a cancer in female population. Patients in more of 50% age over 65 years. 150 patients with breast cancer older then 65 years underwent surgery. T1 and T2 <2 cm patients were treated with quadrantectomy and radiotherapy. T2 >2 cm and T3 patients underwent radical mastectomy. T4 patients were treated with neoadjuvant chemotherapy before surgery. Mean follow up was 48 (range 12-78) mounths. 43 patients (28.6%) had a progression of the neoplasia. Five years mortality rate was 18.6%. Surgery nowadays represents the treatment of choice for breast cancer even in elderly woman. Associated diseases in these patients shouldn’t always considered an absolute contraindication for surgery.