title: Social context and outcomes for the ageing breast cancer patient: considerations for clinical practitioners.
abstract: Current incidence, prevalence and survival rates determine that breast cancer is primarily a disease of older women. This integrative essay provides an extensive review of the literature on (i). the social and psychological factors that influence adjustment to breast cancer and survival from it, (ii). the social and health status of older women, and (iii). the medical treatment of older breast cancer patients. It is concluded that while psychological orientation to the disease, coping strategies and functional continuities of breast cancer patients are important for disease outcome, adjustment to and survival from breast cancer by older women may be compromised by the social context - with respect to marriage and intimate ties, social participation, socio-economic status, and mental and physical health. The paper concludes with the suggestion that clinical practitioners need to be aware of the both the resources of, and limitations facing the older breast cancer patient, and with the provision of specific recommendations about the clinical management of this population for nurses and other health professionals.
authors.affiliation: Faculty of Pharmacy, Department of Public Health Science and Institute for Human Development, Life Course and Aging, University of Toronto, Ontario, Canada. p.ballantyne@utoronto.ca
authors.forename: Peri J
authors.initials: PJ
authors.lastname: Ballantyne
mesh_terms: D000223:Adaptation, Psychological; D017677:Age Distribution; D000368:Aged / Q000523:psychology*; D000375:Aging / Q000523:psychology*; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008393:Marriage / Q000523:psychology; D008603:Mental Health; D020380:Needs Assessment; D024802:Nurse's Role; D011788:Quality of Life; D012803:Sick Role; D012917:Social Adjustment; D012931:Social Environment; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control; D014930:Women / Q000193:education / Q000523:psychology*; D016387:Women's Health