Undertreatment Strongly Decreases Prognosis of Breast Cancer in Elderly Women

Bouchardy, Christine; Rapiti, Elisabetta; Fioretta, G; Laissue, Paul; Neyroud-Caspar, Isabelle; Schäfer, Peter; Kurtz, John M.; Sappino, André‐Pascal; Vlastos, Georges

doi:10.1200/jco.2003.02.046

Cited by 478 publications

(334 citation statements)

References 19 publications

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“…As a consequence, published data report on non-evidence based adjustments of treatment guidelines and increased likelihood of under-treatment with a possible negative effect on survival. [6][7][8] Implementation of the CGA (comprehensive geriatric assessment), which has been shown beneficial for several outcomes in acute geriatric care wards, 9,10 is considered to be the most appropriate way to adapt to the multiple needs and restrictions of older patients. 11 This method comprises four consecutive steps: (i) identifying patients who can benefit from a CGA; (ii) assessing these patients; (iii) developing recommendations for geriatric interventions based on the detected problems by the CGA; and (iv) implementing these recommendations.…”

Section: Introductionmentioning

confidence: 99%

Multicenter implementation of geriatric assessment in Belgian patients with cancer: A survey on treating physicians' general experiences and expectations

Kenis

Heeren

Bron

et al. 2014

Journal of Geriatric Oncology

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Section: Introductionmentioning

confidence: 99%

Multicenter implementation of geriatric assessment in Belgian patients with cancer: A survey on treating physicians' general experiences and expectations

Kenis

Heeren

Bron

et al. 2014

Journal of Geriatric Oncology

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“…Compared to younger women, older women with breast cancer are less likely to be diagnosed via needle biopsy and triple assessment, less likely to undergo primary and axillary node surgery, less likely to receive radiotherapy following breast-conserving surgery, and less likely to receive chemotherapy (Busch et al, 1996;Hérbert-Croteau et al, 1999;Mandelblatt et al, 2000;Bouchardy et al, 2003;Gennari et al, 2004;Wyld et al, 2004;Giordano et al, 2005). Such management of older women is likely to lead to poor local control, recurrence of the disease and excess mortality (COIN, 1999;BASO, 2005;SIGN, 2005).…”

mentioning

confidence: 99%

Non-standard management of breast cancer increases with age in the UK: a population based cohort of women ⩾65 years

Lavelle

Todd

Moran³

et al. 2007

Br J Cancer

114

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Evidence suggests that compared to younger women, older women are less likely to receive standard management for breast cancer. Whether this disparity persists once differences in tumour characteristics have been adjusted for has not been investigated in the UK. A retrospective cohort study involving case note review was undertaken, based on the North Western Cancer Registry database of women aged X65 years, resident in Greater Manchester with invasive breast cancer registered over a 1-year period (n ¼ 480). Adjusting for tumour characteristics associated with age by logistic regression analyses, older women were less likely to receive standard management than younger women for all indicators investigated. Compared to women aged 65 -69 years, women aged X80 years with operable (stage 1 -3a) breast cancer have increased odds of not receiving triple assessment (OR ¼ 5.5, 95% confidence interval (CI): 2.1 -14.5), not receiving primary surgery (OR ¼ 43.0, 95% CI: 9.7 -191.3), not undergoing axillary node surgery (OR ¼ 27.6, 95% CI: 5.6 -135.9) and not undergoing tests for steroid receptors (OR ¼ 3.0, 95% CI: 1.7 -5.5). Women aged 75 -79 years have increased odds of not receiving radiotherapy following breast-conserving surgery compared to women aged 65 -69 years (OR ¼ 11.0, 95% CI: 2.0 -61.6). These results demonstrate that older women in the UK are less likely to receive standard management for breast cancer, compared to younger women and this disparity cannot be explained by differences in tumour characteristics.

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“…Elderly breast cancer patients are often undertreated and have a worse outcome [57] compared with younger patients. Alternatives to conventional surgery as minimally invasive approaches may allow these patients with multiple comorbid conditions to be suitable for local treatments and be cured.…”

Section: Implications For Breast Cancer Managementmentioning

confidence: 99%

Minimally Invasive Approaches for Diagnosis and Treatment of Early-Stage Breast Cancer

Vlastos

Verkooijen

2007

The Oncologist

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LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Describe the minimally invasive approaches to breast cancer diagnosis and treatment.2. List the strengths and weaknesses of minimally invasive diagnostic and treatment procedures.3. Select appropriate patients for minimally invasive approaches to breast cancer diagnosis and treatment.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTBreast cancer management has been evolving toward minimally invasive approaches. Image-guided percutaneous biopsy techniques provide accurate histologic diagnosis without the need for surgical biopsy. Breast conservation therapy has become the treatment standard for earlystage breast cancer. Sentinel lymph node biopsy is a new procedure that can predict axillary lymph node status without the need of axillary lymph node dissection. The next challenge is to treat primary tumors without surgery. For this purpose, several new minimally invasive procedures, including radiofrequency ablation, interstitial laser ablation, focused ultrasound ablation, and cryotherapy, are currently under development and may offer effective tumor management and provide treatment options that are psychologically and cosmetically more acceptable to the patients than are traditional surgical therapies. In this review, we give an overview of minimally invasive approaches for the diagnostic and therapeutic management of early-stage breast cancer. The Oncologist 2007;12: [1][2][3][4][5][6][7][8][9][10]

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Undertreatment Strongly Decreases Prognosis of Breast Cancer in Elderly Women

Abstract: Half of elderly patients with breast cancer are undertreated, with strongly decreased specific survival as a consequence. Treatments need to be adapted to the patient's health status, but also should offer the best chance of cure.

Cited by 478 publications

References 19 publications

Multicenter implementation of geriatric assessment in Belgian patients with cancer: A survey on treating physicians' general experiences and expectations

Multicenter implementation of geriatric assessment in Belgian patients with cancer: A survey on treating physicians' general experiences and expectations

Non-standard management of breast cancer increases with age in the UK: a population based cohort of women ⩾65 years

Minimally Invasive Approaches for Diagnosis and Treatment of Early-Stage Breast Cancer

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