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Crit Rev Oncol Hematol. 2004 Jan;49(1):69-75.

A comprehensive geriatric intervention detects multiple problems in older breast cancer patients.

Author information

1
Senior Adult Oncology, H. Lee Moffitt Cancer Center, University of South Florida, 12902 Magnolia Drive, Tampa, FL 33612, USA. extermann@moffitt.usf.edu

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.

PMID:
14734156
[Indexed for MEDLINE]

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