Geriatric Assessment in Older Patients with Breast Cancer

Authors:
Heidi KlepinFrom Wake Forest University, Winston-Salem, North Carolina; University of Rochester Medical Center, Rochester, New York; and City of Hope, Duarte, California.

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Supriya MohileFrom Wake Forest University, Winston-Salem, North Carolina; University of Rochester Medical Center, Rochester, New York; and City of Hope, Duarte, California.

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Arti HurriaFrom Wake Forest University, Winston-Salem, North Carolina; University of Rochester Medical Center, Rochester, New York; and City of Hope, Duarte, California.

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Volume/Issue:
Volume 7: Issue 2
Online Publication Date:
Feb 2009
DOI:
https://doi.org/10.6004/jnccn.2009.0016
Full access

Most cases of breast cancer are diagnosed in older adults. Older women have an increased risk for breast cancer–specific mortality and are at higher risk for treatment-associated morbidity than younger women. However, they are also less likely to be offered preventive care or adjuvant therapy for this disease. Major gaps in evidence exist regarding the optimal evaluation and treatment of older women with breast cancer because of significant underrepresentation in clinical trials. Chronologic age alone is an inadequate predictor of treatment tolerance and benefit in this heterogeneous population. Multiple issues uniquely associated with aging impact cancer care, including functional impairment, comorbidity, social support, cognitive function, psychological state, and financial stress. Applying geriatric principles and assessment to this older adult population would inform decision making by providing estimates of life expectancy and identifying individuals most vulnerable to morbidity. Ongoing research is seeking to identify which assessment tools can best predict outcomes in this population, and thus guide experts in tailoring treatments to maximize benefits in older adults with breast cancer.

Correspondence: Arti Hurria, MD, Cancer and Aging Research Program, City of Hope, 1500 East Duarte Road, Duarte, CA 91001. E-mail: ahurria@coh.org
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Copyright:
Copyright © 2009 by the National Comprehensive Cancer Network 2009
Page Numbers:
11
Article Category:
Research Article
Received:
14 Aug 2008
Accepted:
27 Oct 2008
Print Publication Date:
01 Feb 2009
Online Publication Date:
Feb 2009
Keywords:
Geriatric assessment; breast cancer; comorbidity; cognition; polypharmacy; nutrition; distress; functional status
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