86 Adequate Assessment Can Affect the Management of Breast Cancer in The Geriatric Population

Abstract

Abstract Background Breast cancer (BC) risk increases with age; about a third of patients are diagnosed in age older than 70. Treatment of this age group remains a thorny issue leading to inferior outcome with lower survival rate compared to younger patients. Aim We aimed to evaluate performance status tools as well as the outcome of management of breast cancer in the geriatric population. Method We have conducted a retrospective database analysis looking into the management of breast cancer patients older than 65 years old presenting to our unit during the period between June 2015 to June 2019. All patients had triple assessment as well as multimodality performance status assessment with their treatment modalities and outcomes recorded and assessed. Results We have included 578 patients, 0.8% male and 99.2 % female, and our patients mean age was 71 years. Most of our patients scored one or two on the WHO/ ECOG performance status score, Clinical Frailty Score, as well as ASA-PS score. 3.2% had no treatment, 4.3% had endocrine therapy only, 0.5% had primary endocrine therapy followed by surgery, 92.3 % underwent surgery with 4.1% complication rate. Patients who underwent breast-conserving surgery had adjuvant breast radiotherapy, and 23.7% had adjuvant chest wall radiotherapy, 78.8% had adjuvant endocrine treatment and 4.8% had adjuvant chemotherapy out of which 30.7% had adjuvant chemotherapy and Herceptin. Conclusions Patients’ age should trigger the use of objective assessment tools while assessing elderly patients with a new breast cancer diagnosis, and treatment modalities offered should be individualised to reach the optimum outcome.