Management of Breast Cancer in Older Women

The second, updated edition of __Management of Breast Cancer in Older Women__ offers the reader evidence-based knowledge to support the care of older patients with breast cancer. It presents the most up-to-date research and clinical practice from leading specialists across a range of fields that come into contact with older breast cancer patients. With new chapters on nursing and clinical trials in older women, as well as patient perspectives and the issues of managing patients with cognitive impairment, the book offers a new focus on this increasingly common and important group of patients. Multidisciplinary in its approach, this book covers all the bases for managing breast cancer in older women. The full range of therapeutic options is presented, as well as the epidemiology and specific psychosocial considerations for older patients. Medical, surgical and radiation oncologists, breast nurses, gerontologists and all healthcare professionals involved in the management of older breast cancer patients will benefit from this unique and important work. Front Matter ....Pages i-x Clinical Epidemiology and the Impact of Co-morbidity on Survival (Adri C. Voogd, Marieke J. Louwman, Jan Willem W. Coebergh)....Pages 1-14 Mammographic Breast Screening in Older Women (Lynda Wyld, Rosalind Given-Wilson)....Pages 15-36 Clinical Assessment: Comprehensive Geriatric Assessment (Siri Rostoft)....Pages 37-43 Multi-disciplinary Geriatric Oncology Clinics (F. Ugolini, L. Beishon, M. W. Reed, A. Stotter, J. Wright, T. G. Robinson)....Pages 45-58 Primary Endocrine Therapy (Jenna Morgan, Lynda Wyld)....Pages 59-78 General and Local Anesthetics (Irwin Foo, Faisal Jafar)....Pages 79-96 The Surgical Management of Breast Cancer in Elderly Women (Fiammetta Ugolini, Malcolm Reed, Lynda Wyld, Riccardo A. Audisio)....Pages 97-116 Breast Reconstruction Surgery in Older Women (Anne Shrestha, Lynda Wyld)....Pages 117-133 Adjuvant Endocrine Therapy (Amelia McCartney, Giuseppina Sanna, Laura Biganzoli)....Pages 135-152 Adjuvant Systemic Therapy (Nicolò Matteo Luca Battisti, Alistair Ring)....Pages 153-173 Adjuvant Radiotherapy (Ian Kunkler)....Pages 175-192 Prevention and Treatment of Skeletal Complications (Robert Coleman)....Pages 193-218 Medical Management of Advanced Disease (Hans Wildiers)....Pages 219-228 The Assessment of the Older Woman with Breast Cancer (Lodovico Balducci)....Pages 229-238 Nurses’ Role in Care of Older Women with Breast Cancer (Vrutika Prajapati, Sarah Rotstein, Sharmy Sarvanantham)....Pages 239-250 Research, Clinical Trials and Evidence-Based Medicine for Older Patients with Breast Cancer (M. E. Hamaker, N. A. de Glas)....Pages 251-261 I was looking at Mrs T – all 45 kilos of her – with somewhat puzzled thoughts. I had prescribed her capecitabine at very prudent doses, in view of her 91-year-old kidneys and physiology. She had reduced my treatment even further, “because it was making her tired.” As a result, she was taking a grand total of 500 mg of capecitabine a day. Yet, her metastatic, ER/PR-negative, Her2-positive breast cancer was undoubtedly responding. Her pain was improving and her chest mass was shrinking, as were her lung metastases... What was the secret of that response? Were Mrs T’s kidneys eli- nating even less drug than predicted by her creatinine clearance? Was her sarcopenia altering drug distribution? Was she absorbing more drug than average? Or was her tumor exquisitely sensitive to fluoropyrimidines? “Physicians,” said Voltaire, “pour drugs they know little for diseases they know even less into patients they know no- ing about.” Medicine has made tremendous progress since the eighteenth century. Yet, there are fields where quite a lot remains to be learned. In developed countries, 25% of breast cancers occur in patients aged 75 years and older. Yet, these patients represent only 4% of the population of traditional clinical trials. That ought to let us wonder how relevant data acquired in patients in their 60s are to a nonagenarian. Fortunately, geriatric oncologists have been stepping up to the task and have gen- ated data to help us to treat such patients. "The second, updated edition of Management of Breast Cancer in Older Women offers the reader evidence-based knowledge to support the care of older patients with breast cancer. It presents the most up-to-date research and clinical practice from leading specialists across a range of fields that come into contact with older breast cancer patients. With new chapters on nursing and clinical trials in older women, as well as patient perspectives and the issues of managing patients with cognitive impairment, the book offers a new focus on this increasingly common and important group of patients. Multidisciplinary in its approach, this book covers all the bases for managing breast cancer in older women. The full range of therapeutic options is presented, as well as the epidemiology and specific psychosocial considerations for older patients. Medical, surgical and radiation oncologists, breast nurses, gerontologists and all healthcare professionals involved in the management of older breast cancer patients will benefit from this unique and important work." -- Prové de l'editor This book offers evidence-based clinical knowledge of older patients suffering from breast cancer. It details the full armament of therapeutic options as well as the epidemiology of the disease and specific psychosocial considerations for elderly patients