BACKGROUND: As few older women with breast cancer receive adjuvant chemotherapy, we examined the barriers and perceptions of 24 UK NHS multidisciplinary breast cancer teams to offering this treatment to women ≥70 years. PATIENTS AND METHODS: Questionnaires regarding 803 patients with newly diagnosed breast cancer were completed by specialist teams following discussion or outpatient consultation. RESULTS: Of 803 patients, 116 (14%), all <85 years, were offered chemotherapy and 66 (8%) received it. Only 94 of 309 (30%) of women with high-risk disease were offered chemotherapy, and 53 (17%) received it. The most common reasons for not offering chemotherapy were 'other treatments more appropriate' (usually patients with ER-positive tumours) or 'benefits too small' (63% and 54% of patients, respectively). Co-morbidities and frailty were less common reasons but became more frequent with increasing age. Recommendations regarding chemotherapy were made in the absence of documented HER2 and performance status in 29% and 33%, respectively. Treatment offered varied considerably between cancer centres. CONCLUSIONS: National guidelines need development describing the minimally acceptable data for decision making, incorporating objective fitness measures and specific treatment recommendations. Such guidelines will require educational support for implementation but should standardise care and improve chemotherapy uptake in this increasing population of older patients.
BACKGROUND: As few older women with breast cancer receive adjuvant chemotherapy, we examined the barriers and perceptions of 24 UK NHS multidisciplinary breast cancer teams to offering this treatment to women ≥70 years. PATIENTS AND METHODS: Questionnaires regarding 803 patients with newly diagnosed breast cancer were completed by specialist teams following discussion or outpatient consultation. RESULTS: Of 803 patients, 116 (14%), all <85 years, were offered chemotherapy and 66 (8%) received it. Only 94 of 309 (30%) of women with high-risk disease were offered chemotherapy, and 53 (17%) received it. The most common reasons for not offering chemotherapy were 'other treatments more appropriate' (usually patients with ER-positive tumours) or 'benefits too small' (63% and 54% of patients, respectively). Co-morbidities and frailty were less common reasons but became more frequent with increasing age. Recommendations regarding chemotherapy were made in the absence of documented HER2 and performance status in 29% and 33%, respectively. Treatment offered varied considerably between cancer centres. CONCLUSIONS: National guidelines need development describing the minimally acceptable data for decision making, incorporating objective fitness measures and specific treatment recommendations. Such guidelines will require educational support for implementation but should standardise care and improve chemotherapy uptake in this increasing population of older patients.
Authors: Nita H Mukand; Naomi Y Ko; Nadia A Nabulsi; Colin C Hubbard; Brian C-H Chiu; Kent F Hoskins; Gregory S Calip Journal: Breast Cancer Date: 2021-11-19 Impact factor: 4.239
Authors: Nicolò Matteo Luca Battisti; Catherine A Welch; Michael Sweeting; Mark de Belder; John Deanfield; Clive Weston; Michael D Peake; David Adlam; Alistair Ring Journal: JACC CardioOncol Date: 2022-06-21
Authors: Gary Ko; Julie Hallet; Katarzyna J Jerzak; Wing Chan; Natalie Coburn; Victoria Barabash; Frances C Wright; Nicole J Look Hong Journal: Ann Surg Oncol Date: 2022-10-18 Impact factor: 4.339
Authors: Allison Magnuson; Mina S Sedrak; Cary P Gross; William P Tew; Heidi D Klepin; Tanya M Wildes; Hyman B Muss; Efrat Dotan; Rachel A Freedman; Tracey O'Connor; William Dale; Harvey J Cohen; Vani Katheria; Anait Arsenyan; Abrahm Levi; Heeyoung Kim; Supriya Mohile; Arti Hurria; Can-Lan Sun Journal: J Clin Oncol Date: 2021-01-14 Impact factor: 44.544
Authors: Elizabeth Trice Loggers; Diana S M Buist; Laura S Gold; Steven Zeliadt; Rachel Hunter Merrill; Ruth Etzioni; Scott D Ramsey; Sean D Sullivan; Larry Kessler Journal: Int J Breast Cancer Date: 2016-07-25
Authors: Suzanne A Eccles; Eric O Aboagye; Simak Ali; Annie S Anderson; Jo Armes; Fedor Berditchevski; Jeremy P Blaydes; Keith Brennan; Nicola J Brown; Helen E Bryant; Nigel J Bundred; Joy M Burchell; Anna M Campbell; Jason S Carroll; Robert B Clarke; Charlotte E Coles; Gary J R Cook; Angela Cox; Nicola J Curtin; Lodewijk V Dekker; Isabel dos Santos Silva; Stephen W Duffy; Douglas F Easton; Diana M Eccles; Dylan R Edwards; Joanne Edwards; D Evans; Deborah F Fenlon; James M Flanagan; Claire Foster; William M Gallagher; Montserrat Garcia-Closas; Julia M W Gee; Andy J Gescher; Vicky Goh; Ashley M Groves; Amanda J Harvey; Michelle Harvie; Bryan T Hennessy; Stephen Hiscox; Ingunn Holen; Sacha J Howell; Anthony Howell; Gill Hubbard; Nick Hulbert-Williams; Myra S Hunter; Bharat Jasani; Louise J Jones; Timothy J Key; Cliona C Kirwan; Anthony Kong; Ian H Kunkler; Simon P Langdon; Martin O Leach; David J Mann; John F Marshall; Lesley Martin; Stewart G Martin; Jennifer E Macdougall; David W Miles; William R Miller; Joanna R Morris; Sue M Moss; Paul Mullan; Rachel Natrajan; James P B O'Connor; Rosemary O'Connor; Carlo Palmieri; Paul D P Pharoah; Emad A Rakha; Elizabeth Reed; Simon P Robinson; Erik Sahai; John M Saxton; Peter Schmid; Matthew J Smalley; Valerie Speirs; Robert Stein; John Stingl; Charles H Streuli; Andrew N J Tutt; Galina Velikova; Rosemary A Walker; Christine J Watson; Kaye J Williams; Leonie S Young; Alastair M Thompson Journal: Breast Cancer Res Date: 2013-10-01 Impact factor: 6.466