title: A comprehensive geriatric intervention detects multiple problems in older breast cancer patients.
abstract: 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.
authors.affiliation: Senior Adult Oncology, H. Lee Moffitt Cancer Center, University of South Florida, 12902 Magnolia Drive, Tampa, FL 33612, USA. extermann@moffitt.usf.edu
authors.forename: Martine
authors.initials: M
authors.lastname: Extermann
authors.forename: Julie
authors.initials: J
authors.lastname: Meyer
authors.forename: Margaret
authors.initials: M
authors.lastname: McGinnis
authors.forename: Theresa T
authors.initials: TT
authors.lastname: Crocker
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Corcoran
authors.forename: Jerry
authors.initials: J
authors.lastname: Yoder
authors.forename: William E
authors.initials: WE
authors.lastname: Haley
authors.forename: Hongbin
authors.initials: H
authors.lastname: Chen
authors.forename: David
authors.initials: D
authors.lastname: Boulware
authors.forename: Lodovico
authors.initials: L
authors.lastname: Balducci
mesh_terms: 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