Charlene Martin
Treatment choices for older women with primary operable breast cancer and cognitive impairment: Results from a prospective, multicentre cohort study
Martin, Charlene; Shrestha, Anne; Morgan, Jenna; Bradburn, Michael; Herbert, Esther; Burton, Maria; Todd, Annaliza; Walters, Stephen; Ward, Sue; Holmes, Geoffrey; Reed, Malcolm; Collins, Karen; Robinson, Thompson G.; Ring, Alistair; Cheung, Kwok Leung; Audisio, Riccardo; Gath, Jacqui; Revell, Deirdre; Green, Tracy; Lifford, Kate; Edwards, Adrian; Chater, Tim; Pemberton, Kirsty; Wyld, Lynda
Authors
Anne Shrestha
Jenna Morgan
Michael Bradburn
Esther Herbert
Maria Burton
Annaliza Todd
Stephen Walters
Sue Ward
Geoffrey Holmes
Malcolm Reed
Karen Collins
Thompson G. Robinson
Alistair Ring
Professor KWOK_LEUNG CHEUNG KWOK_LEUNG.CHEUNG@NOTTINGHAM.AC.UK
Deputy Head of Education & Director of The Bmbs Medicine Programmes
Riccardo Audisio
Jacqui Gath
Deirdre Revell
Tracy Green
Kate Lifford
Adrian Edwards
Tim Chater
Kirsty Pemberton
Lynda Wyld
Abstract
© 2020 The Authors Objectives: The presence of dementia co-existing with a diagnosis of breast cancer may render management more challenging and have a substantial impact on oncological outcomes. The aim of this study was to examine the treatment and outcomes of older women with co-existing cognitive impairment and primary breast cancer. Materials and methods: A prospective, multicentre UK cohort study of women aged 70 years or over with primary operable breast cancer. Patients with and without cognitive impairment were compared to assess differences in treatment and survival outcomes. Results: In total, 3416 women were recruited between 2013 and 2018. Of these, 478 (14%) had a diagnosis of dementia or cognitive impairment, subcategorised as mild, moderate and severely impaired. Up to 85% of women with normal cognition underwent surgery compared to 74%, 61% and 40% with mild, moderate, and severe impairment (p = 0.001). Among women at higher risk of recurrence, the uptake of chemotherapy was 25% for cognitively normal women compared to 20%, 22% and 12% for mild, moderate and severe impairment groups (p = 0.222). Radiotherapy use was similar in the subgroups. Although patients with cognitive impairment had shorter overall survival (HR: 2.10, 95% CI: 1.77–2.50, p < 0.001), there were no statistically significant differences in breast cancer specific or progression-free survival. Conclusion: Cognitive impairment appears to play a significant part in deciding how to treat older women with breast cancer. Standard treatment may be over-treatment for some women with severe dementia and careful consideration must be given to a more tailored approach in these women.
Journal Article Type | Article |
---|---|
Acceptance Date | Dec 9, 2020 |
Online Publication Date | Jan 19, 2021 |
Publication Date | Jun 1, 2021 |
Deposit Date | Jan 5, 2021 |
Publicly Available Date | Jan 5, 2021 |
Journal | Journal of Geriatric Oncology |
Print ISSN | 1879-4068 |
Publisher | Elsevier |
Peer Reviewed | Peer Reviewed |
Volume | 12 |
Issue | 5 |
Pages | 705-713 |
DOI | https://doi.org/10.1016/j.jgo.2020.12.006 |
Public URL | https://nottingham-repository.worktribe.com/output/5201133 |
Publisher URL | https://www.sciencedirect.com/science/article/pii/S1879406820305282 |
Files
PIIS1879406820305282
(1.3 Mb)
PDF
Publisher Licence URL
https://creativecommons.org/licenses/by-nc-nd/4.0/
You might also like
Downloadable Citations
About Repository@Nottingham
Administrator e-mail: discovery-access-systems@nottingham.ac.uk
This application uses the following open-source libraries:
SheetJS Community Edition
Apache License Version 2.0 (http://www.apache.org/licenses/)
PDF.js
Apache License Version 2.0 (http://www.apache.org/licenses/)
Font Awesome
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2024
Advanced Search