A comprehensive geriatric intervention detects multiple problems in older breast cancer patients.
Studies of comprehensive geriatric assessment (CGA) have shown the importance of follow-up for effectiveness, but this has not been tested in an oncology clinic. In this pilot study, we enrolled 15 early breast cancer patients, aged 70 and older. They received a multidisciplinary CGA every 3 months and structured follow-up from the SAOP nurse practitioner, dietitian, social worker, and pharmacist according to risk. Total follow-up was 6 months. Median age of evaluable patients was 79 years (range 72-87). Median number of comorbidities by Cumulative Index Rating Scale-Geriatric (CIRS-G) was 5 (3-9) at baseline. Ten patients were at pharmacological risk, five at psychosocial risk, and eight at nutritional risk. Patients presented on average six problems initially, and three new problems during follow-up. The intervention directly influenced oncological treatment in four cases. It ensured continuity/coordination of care in seven cases. Success rate in addressing problems was 87%. Mean Functional Assessment of Cancer Treatment-Breast (FACT-B) scores improved from 110.5 (S.D. 16.7) to 116.3 (S.D. 16.5) (t=0.025). Function and independence were maintained.


CONCLUSIONS
Older patients with early breast cancer have a high prevalence of comorbidity. A CGA with follow-up has potential for improving the treatment and prognosis of these patients and is feasible in an academic oncology setting.
Extermann
Martine
M
Senior Adult Oncology, H. Lee Moffitt Cancer Center, University of South Florida, 12902 Magnolia Drive, Tampa, FL 33612, USA. extermann@moffitt.usf.edu
Meyer
Julie
J
McGinnis
Margaret
M
Crocker
Theresa T
TT
Corcoran
Mary Beth
MB
Yoder
Jerry
J
Haley
William E
WE
Chen
Hongbin
H
Boulware
David
D
Balducci
Lodovico
L
D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006282:Health Personnel; D006801:Humans; D010865:Pilot Projects; D011788:Quality of Life; D012306:Risk; D016896:Treatment Outcome