Optimal Breast Cancer Treatment for Older Women

Core Concepts

Shared decision-making crucial for tailored breast cancer treatment in older women.

Abstract

Patient-centered care vital for older women with early-stage breast cancer. Decision-making involves weighing treatment options based on individual preferences and clinical necessity. Shared decision-making enhances patient care by considering risks, benefits, and patient preferences. De-escalation of surgery and radiation therapy may be appropriate for some older patients. Systemic therapy recommendations vary based on breast cancer subtype and patient characteristics.

Stats

"Currently more than 30% of new breast cancer diagnoses are in women age 70 and older." "More than 70% of women with breast cancer in this older population will receive axillary surgery and/or radiation." "For many patients with early, node-negative breast cancers with favorable tumor characteristics, less extensive surgery may be an appropriate option."

Quotes

"High quality shared decision-making considers a woman's risk of recurrence, her tumor characteristics, her overall prognosis based on her general health, the lag-time to benefit from the treatment, and her values and preferences." "Just at baseline, we know that mastectomy is a harder operation, it's a harder recovery."

Key Insights Distilled From

Less Therapy May Suit Older Patients With Breast Cancer

by Neil Osterwe... at www.medscape.com 06-14-2023

https://www.medscape.com/viewarticle/993201

Deeper Inquiries

How can shared decision-making be further encouraged in clinical practice?

Shared decision-making can be further encouraged in clinical practice by implementing structured decision aids, providing clear and unbiased information to patients about their treatment options, involving patients in the decision-making process from the beginning, and ensuring that healthcare providers are trained in patient-centered communication. Additionally, creating a supportive environment that values patient preferences, concerns, and values can help facilitate shared decision-making. Utilizing tools such as decision aids, patient decision aids, and decision coaching can also enhance the shared decision-making process by empowering patients to actively participate in their care.

Is there a risk of undertreatment in older breast cancer patients with the de-escalation of therapy?

While de-escalation of therapy in older breast cancer patients can be a valid approach to minimize treatment burden and potential side effects, there is a risk of undertreatment if not carefully managed. It is essential to consider each patient's individual characteristics, tumor biology, comorbidities, and preferences when deciding on the extent of treatment de-escalation. Close monitoring, regular follow-ups, and shared decision-making between healthcare providers and patients are crucial to ensure that undertreatment does not compromise the oncological outcomes or quality of life of older breast cancer patients.

How can advancements in personalized medicine impact the treatment of older patients with breast cancer?

Advancements in personalized medicine can significantly impact the treatment of older patients with breast cancer by tailoring therapies to individual patient characteristics, such as tumor biology, genetic makeup, and comorbidities. Personalized medicine allows for a more precise and targeted approach to treatment, minimizing unnecessary interventions and potential side effects. By utilizing biomarkers, genetic testing, and molecular profiling, healthcare providers can identify the most effective treatment options for older patients with breast cancer, taking into account their unique needs and preferences. This personalized approach can lead to improved treatment outcomes, reduced toxicity, and better quality of life for older patients undergoing breast cancer treatment.