Introduction Since older patients with breast cancer are underrepresented in clinical trials, an oncogeriatric approach is advocated to guide treatment decisions. However, the effect on outcomes is... Show moreIntroduction Since older patients with breast cancer are underrepresented in clinical trials, an oncogeriatric approach is advocated to guide treatment decisions. However, the effect on outcomes is unclear. The aim of this study was to compare treatments and outcomes between patients treated in an oncogeriatric and a standard care setting. Methods Patients aged >= 70 years with early stage breast cancer were included. Theoncogeriatric cohortcomprised unselected patients from the Moffitt Cancer Center, and thestandard cohortpatients from a Dutch population-based cohort. Cox models were used to characterize the influence of care setting on recurrence risk and overall mortality. Results Overall, 268 patients were included in the oncogeriatric and 1932 patients in the standard cohort. Patients in the oncogeriatric cohort were slightly younger, had more comorbidity, and received more adjuvant endocrine therapy and chemotherapy. Oncogeriatric care was associated with a lower risk of recurrence, which remained significant after adjustment for patient and tumour characteristics [hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.44-0.99]. Oncogeriatric care was also associated with a lower overall mortality, which also remained significant after adjustment for patient and tumour characteristics (HR 0.69, 95% CI 0.55-0.87). Conclusions Patients treated in the oncogeriatric care setting had a lower risk of recurrence, which may be explained by more systemic treatment. Overall mortality was also lower, but other explanations besides care setting could not be ruled out as the cohorts had different patient profiles. Future studies need to clarify the impact of an oncogeriatric approach on outcomes. Show less
Breast cancer is the most common malignancy diagnosed in women1. The incidence of breast cancer increases with age; currently, in developed countries more than 40% of breast cancer patients is 65... Show moreBreast cancer is the most common malignancy diagnosed in women1. The incidence of breast cancer increases with age; currently, in developed countries more than 40% of breast cancer patients is 65 years or older at diagnosis1. In the Netherlands in 2011, 5,441 women aged 65 years or older were diagnosed with breast cancer2. The remaining life expectancy of persons aged 65 is still increasing, from almost 19 years in 1980, up to more than 21 years in 2010. Moreover, in last decades the birth rate has decreased, resulting in a higher proportion of older persons in the general population3. Both an increasing life expectancy and the increasing number of elderly in the population will further enhance the number of elderly women confronted with breast cancer Show less
Kiderlen, M.; Glas, N.A. de; Bastiaannet, E.; Water, W. van de; Craen, A.J.M. de; Guicherit, O.R.; ... ; Liefers, G.J. 2014
