Influence of geriatric oncology consultation on the management of breast cancer in older women: a French population-based study.
OBJECTIVE
The objective of the present population-based study was to assess the impact of geriatric oncology consultation on the management of elderly patients with breast cancer and to identify the predictive factors of breast cancer treatment in this population.


METHODS
A total of 206 women aged 75 years and older with breast cancer, diagnosed from January 2007 to December 2009 were included. The independent impact of geriatric oncology consultation on treatment was analyzed using multivariate logistic regression with adjustment for the other predictive factors of treatment.


RESULTS
Patients who had a geriatric oncology consultation (19.4%) had more comorbidities (Charlson Comorbidity Index ≥ 1; P = 0.02), more advanced tumors (P = 0.025), more aggressive tumors (P = 0.029), were more likely to receive mastectomy and adjuvant therapy (P < 0.0001); and less likely to be treated by breast-conserving surgery and adjuvant therapy (P = 0.003). Regarding the geriatric oncology database, 36 of the 40 patients consulted a geriatrician about oncological treatment, and 27 of these 36 patients received the treatment suggested by the geriatrician. For the whole population, geriatric oncology consultation remained a positive predictor for mastectomy and adjuvant therapy (odds ratio 2.32, P = 0.043), and a negative predictor for breast-conserving surgery and adjuvant therapy (odds ratio 0.38, P = 0.048).


CONCLUSIONS
In the present study, we found that treatment of patients who underwent a geriatric oncology consultation generally followed the geriatricians' recommendations. The geriatric oncology consultation was a positive predictor of mastectomy and adjuvant therapy, and a negative predictor of breast-conserving surgery and adjuvant therapy.
Department of Geriatric Internal Medicine, Hospital of Champmaillot, University Hospital, Dijon Cedex, France.
Sophie
S
Somana-Ehrminger
Tienhan S
TS
Dabakuyo
Patrick
P
Manckoundia
Samiratou
S
Ouédraogo
Sophie
S
Marilier
Patrick
P
Arveux
Valérie
V
Quipourt
D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology / Q000628:therapy*; D003131:Combined Modality Therapy; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D015577:Geriatric Assessment; D006801:Humans; D016017:Odds Ratio; D011159:Population Surveillance; D012017:Referral and Consultation; D012189:Retrospective Studies
breast cancer; elderly; geriatric oncology consultation; treatment