How do we manage breast cancer in the elderly patients? A survey among members of the British Association of Surgical Oncologists (BASO).

AIMS

To frame the attitude and perception of breast surgeons in the UK toward the increasing number of older breast cancer patients.

METHODS

A 15-item questionnaire was designed to inquire on the definition of elderly, clinical management, age-related differences in surgical treatment, interaction with geriatricians, operative risk assessment, and surveyed identification/descriptive data. The questionnaire was sent to all 350 ABS associates (Association of Breast Surgery) at the British Association of Surgical Oncology (BASO).

RESULTS

A 150 questionnaires were returned (compliance 43%) providing the largest sample of breast surgical specialist overview on this topic. The major part of the surveyed (44%) stated age does not stand as the most relevant factor on its own in identifying a patient as "elderly", nor in offering surgical management (98%) and in dealing with the axilla (75%). The surveyed are aware of the burden of this epidemiological problem and would rather finalise the decision-making process based on multiple factors. This is to tailor the most appropriate treatment aiming to improving quality of life (42%) and quality adjusted survival (40%). Although most breast surgeons are inclined to discuss their onco-geriatric patients with geriatricians on a regular (32%) or occasional (42%) basis, no geriatric assessment is routinely utilised (82%) and the operative risk is predicted with ASA (45%). These figures confirm the surveyed breast surgeons in the UK are not biased by an ageistic approach, and aim to achieve a global well-being to the older patients with breast cancer.

CONCLUSIONS

This survey confirms our lack of knowledge in the management of elderly patients affected by breast cancer. Taken into account the limitations of a survey, we are pleased to confirm the performance of the largest part of breast surgeons at BASO is not biased by an ageist mentality.