Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA.
J Natl Cancer Inst. 2021 Apr 6;113(4):355-359. doi: 10.1093/jnci/djaa079.
Caring for older patients with breast cancer presents unique clinical considerations because of preexisting and competing comorbidity, the potential for treatment-related toxicity, and the consequent impact on functional status. In the context of the COVID-19 pandemic, treatment decision making for older patients is especially challenging and encourages us to refocus our treatment priorities. While we work to avoid treatment delays and maintain therapeutic benefit, we also need to minimize the risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposures, myelosuppression, general chemotherapy toxicity, and functional decline. Herein, we propose multidisciplinary care considerations for the aging patient with breast cancer, with the goal to promote a team-based, multidisciplinary treatment approach during the COVID-19 pandemic and beyond. These considerations remain relevant as we navigate the "new normal" for the approximately 30% of breast cancer patients aged 70 years and older who are diagnosed in the United States annually and for the thousands of older patients living with recurrent and/or metastatic disease.
照顾患有乳腺癌的老年患者具有独特的临床考虑因素，因为存在先前存在的和竞争的合并症、治疗相关毒性的可能性，以及对功能状态的相应影响。在 COVID-19 大流行的背景下，老年患者的治疗决策尤其具有挑战性，并促使我们重新关注我们的治疗重点。虽然我们努力避免治疗延误并保持治疗效果，但我们还需要最大限度地降低严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）暴露、骨髓抑制、一般化疗毒性和功能下降的风险。在此，我们为患有乳腺癌的老年患者提出了多学科护理注意事项，目标是在 COVID-19 大流行期间及以后促进基于团队的多学科治疗方法。这些注意事项仍然是相关的，因为我们在美国每年诊断的大约 30%的 70 岁及以上的乳腺癌患者和数千名患有复发性和/或转移性疾病的老年患者中，正在应对“新常态”。
