Abstract
Objectives
Breast cancer in older women raises a number of discrete issues, including how healthcare
professionals can best decide which patients are candidates for surgery. A pilot study
involving women aged ≥70 years newly diagnosed with early operable primary breast cancer was conducted aiming
to explore the potential value of comprehensive geriatric assessment (CGA).
Materials and Methods
Decision of primary treatment followed consultation with the clinical team and was
not guided by any aspect of this study. CGA, using a validated cancer-specific tool,
was conducted within 6 weeks and 6 months after diagnosis, complemented by formal measures of quality of life (QOL) (using
EORTC QLQ-C30 and QLQ-BR23) and semi-structured interviews. A total of 47 female patients
with a new diagnosis of clinically early (stage 1 or 2; cT0-2N0-1M0) operable primary
breast cancer proven histologically, were recruited.
Results
CGA determined that increasing age (≥80 years) (p = 0.001), greater (≥4) comorbidity (p = 0.022), greater number (≥4) of daily medications (p = 0.002), and slower (≥19 s) timed up and go (TUG) (p = 0.016) score were significantly related to non-surgical treatment at 6 weeks after diagnosis.
Baseline QOL scores were generally good and they remained stable at 6 months follow-up. As opposed to CGA, there was no correlation between QOL scores and
the treatment modality identified. Semi-structured interviews identified themes consistent
with findings from QOL assessment.
Conclusion
The pilot study confirmed the feasibility of conducting CGA in a research setting
which appeared to have value in assessing this patient population. More data will
be required to definitively identify the components for geriatric assessment in this
setting. The study has now extended into two more centres.
Keywords
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Article info
Publication history
Published online: September 26, 2014
Accepted:
September 12,
2014
Received in revised form:
June 24,
2014
Received:
December 31,
2013
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
