Comprehensive Geriatric Assessment for Older Women with Early-Stage (Non-Metastatic) Breast Cancer—An Updated Systematic Review of the Literature

Reid-Agboola, Chantae; Klukowska, Anita; Malcolm, Francesca L.; Harrison, Cora; Parks, Ruth M.; Cheung, Kwok-Leung

doi:10.3390/curroncol30090602

Cited by 3 publications

(3 citation statements)

References 36 publications

(150 reference statements)

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“…A recent systematic review of utilization of CGA in older women with early stage non-metastatic breast cancer suggested that results of the CGA can be successfully used to assess QOL and predict treatment outcomes (e.g. survival and mortality rate) [ 66 ]. As such, CGA may assist with identifying varying levels of fitness of patients based on an algorithm of factors to determine the most optimal treatment options that increase chances of survival, minimize treatment adverse effects, and decrease risk for poorer physical HrQOL outcomes [ 66 ].…”

Section: Discussionmentioning

confidence: 99%

“…survival and mortality rate) [ 66 ]. As such, CGA may assist with identifying varying levels of fitness of patients based on an algorithm of factors to determine the most optimal treatment options that increase chances of survival, minimize treatment adverse effects, and decrease risk for poorer physical HrQOL outcomes [ 66 ]. Although there is no current gold standard for CGA, our results suggest that age, number of comorbidities, BMI, and financial hardship may be important domains to consider.…”

Section: Discussionmentioning

confidence: 99%

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Physical health-related quality of life trajectories over two years following breast cancer diagnosis in older women: a secondary analysis

Wong,

Levine,

Van Zee

et al. 2024

Support Care Cancer

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Purpose To identify distinct trajectories of physical health-related quality of life (HRQoL) in older women over the first two years following breast cancer diagnosis, and to examine characteristics associated with trajectory group membership. Methods A secondary analysis of a longitudinal study of women diagnosed with stage I-III breast cancer who completed surveys within eight months of diagnosis and six, twelve, and eighteen months later that focuses on a subset of women aged ≥ 65 years (N = 145).Physical HRQoL was assessed using the Physical Component Score (PCS) of the SF-36 Health Survey. Finite mixture modeling identified distinct PCS trajectories. Multivariable logistic regression identified variables predictive of low PCS group membership. Results Two distinct patterns of PCS trajectories were identified. The majority (58%) of women had PCS above the age-based SF-36 population norms and improved slightly over time. However, 42% of women had low PCS that remained low over time. In multivariable analyses, older age, difficulty paying for basics, greater number of medical comorbidities, and higher body mass index were associated with low PCS group membership. Cancer treatment and psychosocial variables were not significantly associated. Conclusion A large subgroup of older women reported very low PCS that did not improve over time. Older age, obesity, multiple comorbidities, and lower socioeconomic status may be risk factors for poorer PCS in women with breast cancer. Incorporating routine comprehensive geriatric assessments that screen for these factors may help providers identify older women at risk for poorer physical HRQoL post breast cancer treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Physical health-related quality of life trajectories over two years following breast cancer diagnosis in older women: a secondary analysis

Wong,

Levine,

Van Zee

et al. 2024

Support Care Cancer

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“…However, due to the heterogeneous nature of the disease and the paucity of evidence specific to older persons, managing breast cancer in this population is challenging [ 5 ]. The under-representation and exclusion of elderly persons from clinical studies led to major gaps in evidence regarding the evaluation and treatment of this population [ 6 , 7 ]. The few studies that focused specifically on breast cancer in elderly women provided some details about the clinicopathological features of the disease in this group and showed that it differs uniquely from the features of the disease in the younger population [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Multicenter Study on Breast Cancer in the Geriatric Population: Insights for Effective Treatment Strategies

Karabulut Gul,

Tepetam,

Benli Yavuz

et al. 2024

Cureus

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Objective: Breast cancer is common among women aged 65 and over. There is a significant lack of evidence regarding the treatment of breast cancer in patients in this age group due to the rare inclusion of these patients in clinical studies. However, it is known that survival in elderly patients with breast cancer is significantly reduced in those not receiving standard therapy. Several factors, including patients’ comorbidities, performance status, life expectancy, and tumor pathological and molecular characteristics, can affect the outcomes of treatment. In this study, we aimed to update the knowledge in this field by assessing these factors among the geriatric population in our multicenter dataset. Methods: This retrospective study analyzed data from 335 breast cancer patients aged 65 and over who received adjuvant radiotherapy at five oncology centers (Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Meram Medical Faculty - Necmettin Erbakan University, Konya, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Umraniye Training and Research Hospital, Istanbul, and Istanbul Oncology Hospital, Istanbul) between May 2010 and September 2022. Demographic, clinical, and pathological data were collected, including age, gender, clinical symptoms, tumor characteristics, treatment approaches, and outcomes. Statistical analyses, including descriptive statistics, Kaplan-Meier analysis, log-rank test, and Cox regression analysis, were performed using IBM SPSS Statistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States), with a significance level of p < 0.05. Results: The tumor characteristics and survival time of 335 breast cancer patients were examined. In the results, performance status, T stage, and perineural invasion were found to be factors affecting the survival of elderly breast cancer patients. In multivariate analysis, it was seen that performance status played an important role as an independent prognostic factor. Conclusion: The treatment of breast cancer in the geriatric age group necessitates a personalized approach, taking into account the patient's overall health status, life expectancy, and comorbidities.

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Advocate-BREAST80+: A Comprehensive Patient and Advocate-Led Study to Enhance Breast Cancer Care Delivery and Patient-Centered Research in Women Aged ≥80 Years

O’Sullivan,

Vierkant,

Larson

et al. 2024

Cancers

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Background: There are limited evidence-based data to guide treatment recommendations for breast cancer (BC) patients ≥80 years (P80+). Identifying and addressing unmet needs are critical. Aims: Advocate-BREAST80+ compared the needs of P80+ vs. patients < 80 years (P80−). Methods: In 12/2021, a REDCap survey was electronically circulated to 6918 persons enrolled in the Mayo Clinic Breast Disease Registry. The survey asked about concerns and satisfaction with multiple aspects of BC care. Results: Overall, 2437 participants responded (35% response rate); 202 (8.3%) were P80+. P80+ were less likely to undergo local regional and systemic therapies vs. P80− (p < 0.01). Notably, P80+ were significantly less satisfied with information about the short and long-term side effects of BC therapies and managing toxicities. P80+ were also less likely to have participated in a clinical trial (p < 0.001) or to want to do so in the future (p = 0.0001). Conclusions: Although P80+ experienced less anxiety and symptom-related distress compared with P80−, they were significantly less satisfied with information regarding the side effects of BC therapies and their management. P80+ were significantly less likely to have participated in a clinical trial or be open to considering this option. Future studies should address educational needs pertaining to side effects and barriers to research participation in P80+.

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Comprehensive Geriatric Assessment for Older Women with Early-Stage (Non-Metastatic) Breast Cancer—An Updated Systematic Review of the Literature

Cited by 3 publications

References 36 publications

Physical health-related quality of life trajectories over two years following breast cancer diagnosis in older women: a secondary analysis

Physical health-related quality of life trajectories over two years following breast cancer diagnosis in older women: a secondary analysis

Multicenter Study on Breast Cancer in the Geriatric Population: Insights for Effective Treatment Strategies

Advocate-BREAST80+: A Comprehensive Patient and Advocate-Led Study to Enhance Breast Cancer Care Delivery and Patient-Centered Research in Women Aged ≥80 Years

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