Older Patients With Triple-Negative Breast Cancer Should Be Assessed Different for Treatment
Enrique Soto Pérez de Celis, MD, MSc, explains that although geriatric patients with breast cancer can be treated similarly to their younger counterparts, more steps are involved in the treatment decision-making process, starting with appropriate assessment of the patient.
Enrique Soto Pérez de Celis, MD, MSc, a geriatric oncologist and researcher in the Department of Geriatrics at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán in Mexico City, Mexico, explains that although geriatric patients with breast cancer can be treated similarly to their younger counterparts, more steps are involved in the treatment decision-making process, starting with appropriate assessment of the patient.
Treating the geriatric patient population in breast cancer should be different than treating the younger population. First, physicians should complete a geriatric assessment with their patients, says Soto Pérez de Celis. There are guidelines recommendations on which tools to use for this and which are most useful for everyday practice. It is important to calculate the patient’s life expectancy without cancer as these patients often have competing risks and other comorbidities, so not all treatment benefits are appropriate in the geriatric patient population.
There are several tolls that can predict toxicities in older patients with breast cancer, and physicians should align the risks and benefits with the patient preferences as well. Older adult may not view prolonging survival as long as possible to be as important as maintaining independence or cognition, or even avoiding symptoms. Physicians should always take into account the patient preferences when making treatment decisions.
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