Objective:To observe the clinical effect and adverse reaction of capecitabine as first-line monotherapy in elderly patients with stage Ⅱa breast cancer.Methods: From June 2002 to June 2005,71 elderly patients with stage Ⅱa breast cancer received chemotherapy(different scheme: capecitabine group and CEF group) after operation.The efficacies and adverse reactions were evaluated and compared between the two groups.Results: The 3-year and 5-year survival rates of patients in capecitabine group were 97.06％ and 94.12％,respectively; the relapse rate was 5.88%; all were comparable to those of CEF group. One of the advantages of capecitabine was its oral administration. The adverse effect of capecitabine was mainly hand-foot syndrome,with an incidence of 82.35%,but was tolerable. The gastrointestinal reaction and bone marrow repression in capecitabine group were significantly lower than those in the CEF group(P<0.01). There was no giving up of treatment due to adverse reactions or fear of chemotherapy in our group. Conclusion: Capecitabine is effective and safe in the treatment of elderly patients with stage Ⅱa breast cancer; it is easy to take,with less adverse effects and better patient compliance.