The global population of older women living with breast cancer is increasing worldwide. Breast cancer is the most common malignancy in females worldwide; its incidence correlates with increasing age. As life expectancy increases and the population ages, understanding the specific considerations for breast cancer in older women becomes increasingly important. This chapter will explore an older patient’s breast cancer journey from the time of screening for breast cancer, treatment options, psychosocial support, prognosis and follow-up care. Older women with breast cancer have unique challenges at various stages of their breast cancer journey, which may affect their treatment choice and experience. There are important considerations for personalising the care of breast cancer in older women which can be categorised into patient-, physician- and system-associated factors. Older women may benefit from more proactive treatment discussions with the wider multidisciplinary team involved in a breast cancer patient’s care to address their specific needs.