Adjuvant chemotherapy in elderly women with breast cancer (AChEW): an observational study identifying MDT perceptions and barriers to decision making
As few older women with breast cancer receive adjuvant chemotherapy, we examined the barriers and perceptions of 24 UK NHS multidisciplinary breast cancer teams to offering this treatment to women ≥70 years. Questionnaires regarding 803 patients with newly diagnosed breast cancer were completed by s...
Gespeichert in:
| Veröffentlicht in: | Annals of oncology 2013-05, Vol.24 (5), p.1211-1219 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1219 |
|---|---|
| container_issue | 5 |
| container_start_page | 1211 |
| container_title | Annals of oncology |
| container_volume | 24 |
| creator | Ring, A. Harder, H. Langridge, C. Ballinger, R.S. Fallowfield, L.J. |
| description | As few older women with breast cancer receive adjuvant chemotherapy, we examined the barriers and perceptions of 24 UK NHS multidisciplinary breast cancer teams to offering this treatment to women ≥70 years.
Questionnaires regarding 803 patients with newly diagnosed breast cancer were completed by specialist teams following discussion or outpatient consultation.
Of 803 patients, 116 (14%), all |
| doi_str_mv | 10.1093/annonc/mds642 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1331089225</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0923753419372576</els_id><sourcerecordid>1331089225</sourcerecordid><originalsourceid>FETCH-LOGICAL-c410t-bdd90ad0b41a21ec5d622fe2d4db54f542cffd2f2556b692f0d9525ccebb21cf3</originalsourceid><addsrcrecordid>eNp10U1vFCEYB3BiNHatHr0aLib1MBYYmC3eNtv6ktR4qfE44eXBpc7ACMw2-0H8vrKZVU-eOPDjycP_j9BLSt5SIttLFUIM5nK0uePsEVpR0cnminD6GK2IZG2zFi0_Q89yvieEdJLJp-iMtW3LKV2v0K-NvZ_3KhRsdjDGsoOkpgP2AcNgIQ0H_BBHCPjBlx3WCVSuUgUDCV9strubb2_eYRVw1BnSXhUfgxpwLrOtMyyE4t3Bh-_48_UdniAZmI4k1ycWa5WSh5RxidiC8bne4FH9qP45euLUkOHF6TxHX9_f3G0_NrdfPnzabm4bwykpjbZWEmWJ5lQxCkbYjjEHzHKrBXeCM-OcZY4J0en6dUesFEwYA1ozalx7ji6WuVOKP2fIpR99NjAMKkCcc0_blpIryZiotFmoSTHnBK6fkh9VOvSU9Mcm-qWJfmmi-len0bMewf7Vf6Kv4PUJqGzU4FJN1ed_bs3kce_q1ouDGsS-BtZn46E2YH0CU3ob_X9W-A0pwarT</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1331089225</pqid></control><display><type>article</type><title>Adjuvant chemotherapy in elderly women with breast cancer (AChEW): an observational study identifying MDT perceptions and barriers to decision making</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Ring, A. ; Harder, H. ; Langridge, C. ; Ballinger, R.S. ; Fallowfield, L.J.</creator><creatorcontrib>Ring, A. ; Harder, H. ; Langridge, C. ; Ballinger, R.S. ; Fallowfield, L.J.</creatorcontrib><description>As few older women with breast cancer receive adjuvant chemotherapy, we examined the barriers and perceptions of 24 UK NHS multidisciplinary breast cancer teams to offering this treatment to women ≥70 years.
Questionnaires regarding 803 patients with newly diagnosed breast cancer were completed by specialist teams following discussion or outpatient consultation.
Of 803 patients, 116 (14%), all <85 years, were offered chemotherapy and 66 (8%) received it. Only 94 of 309 (30%) of women with high-risk disease were offered chemotherapy, and 53 (17%) received it. The most common reasons for not offering chemotherapy were ‘other treatments more appropriate’ (usually patients with ER-positive tumours) or ‘benefits too small’ (63% and 54% of patients, respectively). Co-morbidities and frailty were less common reasons but became more frequent with increasing age. Recommendations regarding chemotherapy were made in the absence of documented HER2 and performance status in 29% and 33%, respectively. Treatment offered varied considerably between cancer centres.
National guidelines need development describing the minimally acceptable data for decision making, incorporating objective fitness measures and specific treatment recommendations. Such guidelines will require educational support for implementation but should standardise care and improve chemotherapy uptake in this increasing population of older patients.</description><identifier>ISSN: 0923-7534</identifier><identifier>EISSN: 1569-8041</identifier><identifier>DOI: 10.1093/annonc/mds642</identifier><identifier>PMID: 23334117</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>adjuvant chemotherapy ; Aged ; Aged, 80 and over ; Aging ; Antineoplastic agents ; Biological and medical sciences ; breast cancer ; Breast Neoplasms - drug therapy ; Chemotherapy, Adjuvant ; clinical decision making ; Decision Making ; elderly women ; Female ; Gynecology. Andrology. Obstetrics ; Humans ; Mammary gland diseases ; Medical sciences ; Medical Staff ; Multiple tumors. Solid tumors. Tumors in childhood (general aspects) ; Pharmacology. Drug treatments ; Surveys and Questionnaires ; Tumors ; Withholding Treatment</subject><ispartof>Annals of oncology, 2013-05, Vol.24 (5), p.1211-1219</ispartof><rights>2013 European Society for Medical Oncology</rights><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c410t-bdd90ad0b41a21ec5d622fe2d4db54f542cffd2f2556b692f0d9525ccebb21cf3</citedby><cites>FETCH-LOGICAL-c410t-bdd90ad0b41a21ec5d622fe2d4db54f542cffd2f2556b692f0d9525ccebb21cf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27292556$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23334117$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ring, A.</creatorcontrib><creatorcontrib>Harder, H.</creatorcontrib><creatorcontrib>Langridge, C.</creatorcontrib><creatorcontrib>Ballinger, R.S.</creatorcontrib><creatorcontrib>Fallowfield, L.J.</creatorcontrib><title>Adjuvant chemotherapy in elderly women with breast cancer (AChEW): an observational study identifying MDT perceptions and barriers to decision making</title><title>Annals of oncology</title><addtitle>Ann Oncol</addtitle><description>As few older women with breast cancer receive adjuvant chemotherapy, we examined the barriers and perceptions of 24 UK NHS multidisciplinary breast cancer teams to offering this treatment to women ≥70 years.
Questionnaires regarding 803 patients with newly diagnosed breast cancer were completed by specialist teams following discussion or outpatient consultation.
Of 803 patients, 116 (14%), all <85 years, were offered chemotherapy and 66 (8%) received it. Only 94 of 309 (30%) of women with high-risk disease were offered chemotherapy, and 53 (17%) received it. The most common reasons for not offering chemotherapy were ‘other treatments more appropriate’ (usually patients with ER-positive tumours) or ‘benefits too small’ (63% and 54% of patients, respectively). Co-morbidities and frailty were less common reasons but became more frequent with increasing age. Recommendations regarding chemotherapy were made in the absence of documented HER2 and performance status in 29% and 33%, respectively. Treatment offered varied considerably between cancer centres.
National guidelines need development describing the minimally acceptable data for decision making, incorporating objective fitness measures and specific treatment recommendations. Such guidelines will require educational support for implementation but should standardise care and improve chemotherapy uptake in this increasing population of older patients.</description><subject>adjuvant chemotherapy</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aging</subject><subject>Antineoplastic agents</subject><subject>Biological and medical sciences</subject><subject>breast cancer</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Chemotherapy, Adjuvant</subject><subject>clinical decision making</subject><subject>Decision Making</subject><subject>elderly women</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Mammary gland diseases</subject><subject>Medical sciences</subject><subject>Medical Staff</subject><subject>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</subject><subject>Pharmacology. Drug treatments</subject><subject>Surveys and Questionnaires</subject><subject>Tumors</subject><subject>Withholding Treatment</subject><issn>0923-7534</issn><issn>1569-8041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10U1vFCEYB3BiNHatHr0aLib1MBYYmC3eNtv6ktR4qfE44eXBpc7ACMw2-0H8vrKZVU-eOPDjycP_j9BLSt5SIttLFUIM5nK0uePsEVpR0cnminD6GK2IZG2zFi0_Q89yvieEdJLJp-iMtW3LKV2v0K-NvZ_3KhRsdjDGsoOkpgP2AcNgIQ0H_BBHCPjBlx3WCVSuUgUDCV9strubb2_eYRVw1BnSXhUfgxpwLrOtMyyE4t3Bh-_48_UdniAZmI4k1ycWa5WSh5RxidiC8bne4FH9qP45euLUkOHF6TxHX9_f3G0_NrdfPnzabm4bwykpjbZWEmWJ5lQxCkbYjjEHzHKrBXeCM-OcZY4J0en6dUesFEwYA1ozalx7ji6WuVOKP2fIpR99NjAMKkCcc0_blpIryZiotFmoSTHnBK6fkh9VOvSU9Mcm-qWJfmmi-len0bMewf7Vf6Kv4PUJqGzU4FJN1ed_bs3kce_q1ouDGsS-BtZn46E2YH0CU3ob_X9W-A0pwarT</recordid><startdate>20130501</startdate><enddate>20130501</enddate><creator>Ring, A.</creator><creator>Harder, H.</creator><creator>Langridge, C.</creator><creator>Ballinger, R.S.</creator><creator>Fallowfield, L.J.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130501</creationdate><title>Adjuvant chemotherapy in elderly women with breast cancer (AChEW): an observational study identifying MDT perceptions and barriers to decision making</title><author>Ring, A. ; Harder, H. ; Langridge, C. ; Ballinger, R.S. ; Fallowfield, L.J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c410t-bdd90ad0b41a21ec5d622fe2d4db54f542cffd2f2556b692f0d9525ccebb21cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>adjuvant chemotherapy</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aging</topic><topic>Antineoplastic agents</topic><topic>Biological and medical sciences</topic><topic>breast cancer</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Chemotherapy, Adjuvant</topic><topic>clinical decision making</topic><topic>Decision Making</topic><topic>elderly women</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Mammary gland diseases</topic><topic>Medical sciences</topic><topic>Medical Staff</topic><topic>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</topic><topic>Pharmacology. Drug treatments</topic><topic>Surveys and Questionnaires</topic><topic>Tumors</topic><topic>Withholding Treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ring, A.</creatorcontrib><creatorcontrib>Harder, H.</creatorcontrib><creatorcontrib>Langridge, C.</creatorcontrib><creatorcontrib>Ballinger, R.S.</creatorcontrib><creatorcontrib>Fallowfield, L.J.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ring, A.</au><au>Harder, H.</au><au>Langridge, C.</au><au>Ballinger, R.S.</au><au>Fallowfield, L.J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adjuvant chemotherapy in elderly women with breast cancer (AChEW): an observational study identifying MDT perceptions and barriers to decision making</atitle><jtitle>Annals of oncology</jtitle><addtitle>Ann Oncol</addtitle><date>2013-05-01</date><risdate>2013</risdate><volume>24</volume><issue>5</issue><spage>1211</spage><epage>1219</epage><pages>1211-1219</pages><issn>0923-7534</issn><eissn>1569-8041</eissn><abstract>As few older women with breast cancer receive adjuvant chemotherapy, we examined the barriers and perceptions of 24 UK NHS multidisciplinary breast cancer teams to offering this treatment to women ≥70 years.
Questionnaires regarding 803 patients with newly diagnosed breast cancer were completed by specialist teams following discussion or outpatient consultation.
Of 803 patients, 116 (14%), all <85 years, were offered chemotherapy and 66 (8%) received it. Only 94 of 309 (30%) of women with high-risk disease were offered chemotherapy, and 53 (17%) received it. The most common reasons for not offering chemotherapy were ‘other treatments more appropriate’ (usually patients with ER-positive tumours) or ‘benefits too small’ (63% and 54% of patients, respectively). Co-morbidities and frailty were less common reasons but became more frequent with increasing age. Recommendations regarding chemotherapy were made in the absence of documented HER2 and performance status in 29% and 33%, respectively. Treatment offered varied considerably between cancer centres.
National guidelines need development describing the minimally acceptable data for decision making, incorporating objective fitness measures and specific treatment recommendations. Such guidelines will require educational support for implementation but should standardise care and improve chemotherapy uptake in this increasing population of older patients.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>23334117</pmid><doi>10.1093/annonc/mds642</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0923-7534 |
| ispartof | Annals of oncology, 2013-05, Vol.24 (5), p.1211-1219 |
| issn | 0923-7534 1569-8041 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1331089225 |
| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | adjuvant chemotherapy Aged Aged, 80 and over Aging Antineoplastic agents Biological and medical sciences breast cancer Breast Neoplasms - drug therapy Chemotherapy, Adjuvant clinical decision making Decision Making elderly women Female Gynecology. Andrology. Obstetrics Humans Mammary gland diseases Medical sciences Medical Staff Multiple tumors. Solid tumors. Tumors in childhood (general aspects) Pharmacology. Drug treatments Surveys and Questionnaires Tumors Withholding Treatment |
| title | Adjuvant chemotherapy in elderly women with breast cancer (AChEW): an observational study identifying MDT perceptions and barriers to decision making |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-01T03%3A39%3A47IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Adjuvant%20chemotherapy%20in%20elderly%20women%20with%20breast%20cancer%20(AChEW):%20an%20observational%20study%20identifying%20MDT%20perceptions%20and%20barriers%20to%20decision%20making&rft.jtitle=Annals%20of%20oncology&rft.au=Ring,%20A.&rft.date=2013-05-01&rft.volume=24&rft.issue=5&rft.spage=1211&rft.epage=1219&rft.pages=1211-1219&rft.issn=0923-7534&rft.eissn=1569-8041&rft_id=info:doi/10.1093/annonc/mds642&rft_dat=%3Cproquest_cross%3E1331089225%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1331089225&rft_id=info:pmid/23334117&rft_els_id=S0923753419372576&rfr_iscdi=true |