A joint geriatric oncology clinic for the management of elderly women diagnosed with breast cancer: the Brighton experience.
Association of Breast Surgery ePoster Library. Zammit C. 05/15/17; 166278; P038
Mr. Charles Zammit
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Abstract
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Introduction:
30% of diagnosis of breast cancer occurs in women aged over 70 years.
The SIOG and EUSOMA task force (2012) recommends primary endocrine therapy (PET) in older women with ER-positive tumours, estimated life expectancy <2–3 years, unfit for, or refusing, surgery. Life expectancy is difficult to estimate and should not be confused with age. Functional and cognitive statuses need to be considered when discussing therapeutic options. Formal geriatric assessment in a joint clinic setting may improve management of these patients and help treatment selection for breast cancer. A dedicated clinic has been established in Brighton in which selected patients are assessed jointly by a geriatrician and a breast surgeon.
Methods:
Cohort study.
Aim: examine the impact of a geriatric-oncology consultation on patients' breast cancer and overall management.
Referral criteria:
- 70 years or older
- Diagnosed with breast cancer, considered unfit for or declining surgery
- Patients on PET who develop disease progression
Results:
74 referrals were seen from June 2015 to October 2016 (age range 70-98 years).
16 patients (21.6 %) subsequently underwent surgical treatment. 7 underwent wide local excision and 9 had mastectomy (1 bilateral). Regarding axillary treatment 9 underwent sentinel node biopsy, 3 had clearance and 4 had no axillary procedure.
Of those not treated surgically 7 (9%) had their endocrine treatment changed and 34 patients (46%) required medical management.
Conclusions:
Assessment in the joint clinic resulted in more patients receiving surgical treatment. Our rate of conversion to surgery fits with data reported in literature.
30% of diagnosis of breast cancer occurs in women aged over 70 years.
The SIOG and EUSOMA task force (2012) recommends primary endocrine therapy (PET) in older women with ER-positive tumours, estimated life expectancy <2–3 years, unfit for, or refusing, surgery. Life expectancy is difficult to estimate and should not be confused with age. Functional and cognitive statuses need to be considered when discussing therapeutic options. Formal geriatric assessment in a joint clinic setting may improve management of these patients and help treatment selection for breast cancer. A dedicated clinic has been established in Brighton in which selected patients are assessed jointly by a geriatrician and a breast surgeon.
Methods:
Cohort study.
Aim: examine the impact of a geriatric-oncology consultation on patients' breast cancer and overall management.
Referral criteria:
- 70 years or older
- Diagnosed with breast cancer, considered unfit for or declining surgery
- Patients on PET who develop disease progression
Results:
74 referrals were seen from June 2015 to October 2016 (age range 70-98 years).
16 patients (21.6 %) subsequently underwent surgical treatment. 7 underwent wide local excision and 9 had mastectomy (1 bilateral). Regarding axillary treatment 9 underwent sentinel node biopsy, 3 had clearance and 4 had no axillary procedure.
Of those not treated surgically 7 (9%) had their endocrine treatment changed and 34 patients (46%) required medical management.
Conclusions:
Assessment in the joint clinic resulted in more patients receiving surgical treatment. Our rate of conversion to surgery fits with data reported in literature.
Introduction:
30% of diagnosis of breast cancer occurs in women aged over 70 years.
The SIOG and EUSOMA task force (2012) recommends primary endocrine therapy (PET) in older women with ER-positive tumours, estimated life expectancy <2–3 years, unfit for, or refusing, surgery. Life expectancy is difficult to estimate and should not be confused with age. Functional and cognitive statuses need to be considered when discussing therapeutic options. Formal geriatric assessment in a joint clinic setting may improve management of these patients and help treatment selection for breast cancer. A dedicated clinic has been established in Brighton in which selected patients are assessed jointly by a geriatrician and a breast surgeon.
Methods:
Cohort study.
Aim: examine the impact of a geriatric-oncology consultation on patients' breast cancer and overall management.
Referral criteria:
- 70 years or older
- Diagnosed with breast cancer, considered unfit for or declining surgery
- Patients on PET who develop disease progression
Results:
74 referrals were seen from June 2015 to October 2016 (age range 70-98 years).
16 patients (21.6 %) subsequently underwent surgical treatment. 7 underwent wide local excision and 9 had mastectomy (1 bilateral). Regarding axillary treatment 9 underwent sentinel node biopsy, 3 had clearance and 4 had no axillary procedure.
Of those not treated surgically 7 (9%) had their endocrine treatment changed and 34 patients (46%) required medical management.
Conclusions:
Assessment in the joint clinic resulted in more patients receiving surgical treatment. Our rate of conversion to surgery fits with data reported in literature.
30% of diagnosis of breast cancer occurs in women aged over 70 years.
The SIOG and EUSOMA task force (2012) recommends primary endocrine therapy (PET) in older women with ER-positive tumours, estimated life expectancy <2–3 years, unfit for, or refusing, surgery. Life expectancy is difficult to estimate and should not be confused with age. Functional and cognitive statuses need to be considered when discussing therapeutic options. Formal geriatric assessment in a joint clinic setting may improve management of these patients and help treatment selection for breast cancer. A dedicated clinic has been established in Brighton in which selected patients are assessed jointly by a geriatrician and a breast surgeon.
Methods:
Cohort study.
Aim: examine the impact of a geriatric-oncology consultation on patients' breast cancer and overall management.
Referral criteria:
- 70 years or older
- Diagnosed with breast cancer, considered unfit for or declining surgery
- Patients on PET who develop disease progression
Results:
74 referrals were seen from June 2015 to October 2016 (age range 70-98 years).
16 patients (21.6 %) subsequently underwent surgical treatment. 7 underwent wide local excision and 9 had mastectomy (1 bilateral). Regarding axillary treatment 9 underwent sentinel node biopsy, 3 had clearance and 4 had no axillary procedure.
Of those not treated surgically 7 (9%) had their endocrine treatment changed and 34 patients (46%) required medical management.
Conclusions:
Assessment in the joint clinic resulted in more patients receiving surgical treatment. Our rate of conversion to surgery fits with data reported in literature.
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