Abstract
The incidence of breast cancer rises with older age, but evidence from the literature, and from audits of current UK practice, suggests that older women with breast cancer may not receive optimal therapy. We present evidence to support the use of comprehensive geriatric assessment of frail patients with breast cancer, to ensure optimisation of co-morbidity management and to facilitate optimal cancer therapy. Assessment should include evaluation of dependence in activities of daily living and cognitive function, which correlate with life expectancy. We present experience from two clinics in the United Kingdom, which were established to improve the management of breast cancer in the older patient, and highlight key recommendations from the National Audit of Breast Cancer in Older People and on-going research.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Jemal A, Siegal R, Ward E, et al. Cancer statistics, 2009. CA Cancer J Clin. 2009;59(4):225–49.
Lewis JH, Kilgore ML, Goldman DP, et al. Participation of patients 65 years of age or older in cancer clinical trials. J Clin Oncol. 2003;21:1383–9.
Hind D, Wyld L, Reed MW. Surgery, with or without tamoxifen, versus tamoxifen alone for older women with operable breast cancer: Cochrane review. Br J Cancer. 2007;96:1025–9.
Fennessy M, Bates T, MacRae K, Riley D, Houghton J, Baum M. Late follow-up of a randomized trial of surgery plus tamoxifen versus tamoxifen alone in women aged over 70 years with operable breast cancer. Br J Surg. 2004;91:699–704.
Biganzoli L, Wildiers H, Oakman C, et al. Management of elderly patients with breast cancer: updated recommendations of the International Society of Geriatric Oncology (SIOG) and European Society of Breast Cancer Specialists (EUSOMA). Lancet Oncol. 2012;13(4):148–60.
Stotter A, Reed MW, Gray LJ, Moore N, Robinson TG. Comprehensive geriatric assessment and predicted 3-year survival in treatment planning for frail patients with early breast cancer. Br J Surg. 2015;102:525–33.
Rubenstein LZ. An overview of comprehensive geriatric assessment: rationale, history, program models, basic components. In: Rubenstein LZ, Wieland D, Bernabei R, editors. Geriatric assessment technology: the state of the art. New York: Springer; 1995.
NCCN Practice Guidelines in Oncology: Senior Adult Oncology. 2009. http://www.nccn.org/professionals/physician_gls/pdf/senior.pdf.
Extermann M, Aapro M, Bernabei R, Cohen HJ, Droz JP, Lichtman S, et al. Task force on CGA of the International Society of Geriatric Oncology. Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG). Crit Rev Oncol Hematol. 2005;55:241–52.
McNeil C. Geriatric oncology clinics on the rise. J Natl Cancer Inst. 2013;105(9):585–6. https://doi.org/10.1093/jnci/djt104. Epub 2013 Apr 16.
Chaïbi P, Magné N, Breton S, Chebib A, Watson S, Duron J-J, et al. Influence of geriatric consultation with comprehensive geriatric assessment on final therapeutic decision in elderly cancer patients. Crit Rev Oncol Hematol. 2011;79:302–7.
Girre V, Falcou MC, Gisselbrecht M, et al. Does a geriatric oncology consultation modify the cancer treatment plan for elderly patients? J Gerontol A Biol Sci Med Sci. 2008;63(7):724–30.
Chapman AE, Swartz K, Schoppe J, Arenson C. Development of a comprehensive multidisciplinary geriatric oncology center, the Thomas Jefferson University experience. J Geriatr Oncol. 2014;5:164–70.
Stotter A, Tahir M, Pretorius RS, Robinson T. Experiences of a multidisciplinary elderly breast cancer clinic: using the right specialists, in the same place, with time. In: Reed MW, Audisio RA, editors. Management of breast cancer in older women: London: Springer; 2010. p. 109–23.
Extermann M, Meyer J, McGinnis M, et al. A comprehensive geriatric intervention detects multiple problems in older breast cancer patients. Crit Rev Oncol Hematol. 2004;49:69–75.
Isaacs B. The challenge of geriatric medicine: Oxford: Oxford University Press; 1992.
Ware J, Snyder M, Wright R, Davies A. Defining and measuring patients satisfaction with medical care. Eval Program Plann. 1983;6:247–63.
Sitzia J, Wood N. Patient satisfaction: a review of issues and concepts. Soc Sci Med. 1997;45:1829–43.
Kearly K,Freeman G, Heath A. An exploration of the value of personal doctor-patient relationship in general practice. Br J Gen Pract 2001; 51: 712–8. 48) Williams B, Coyle J, Healy D. The meaning of patient satisfaction: an explanation of high reported levels. Soc Sci Med 1998; 47:1351–1359.
Bergenmar M, Nylén U, Lidbrink E, Bergh J, Brandberg Y. Improvements in patient satisfaction at an outpatient clinic for patients with breast cancer. Acta Oncol. 2006;45(5):550–8.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Ugolini, F., Beishon, L., Reed, M.W., Stotter, A., Wright, J., Robinson, T.G. (2019). Multi-disciplinary Geriatric Oncology Clinics. In: Reed, M., Audisio, R. (eds) Management of Breast Cancer in Older Women. Springer, Cham. https://doi.org/10.1007/978-3-030-11875-4_4
Download citation
DOI: https://doi.org/10.1007/978-3-030-11875-4_4
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-11874-7
Online ISBN: 978-3-030-11875-4
eBook Packages: MedicineMedicine (R0)