E-poster Presentation 2014 World Cancer Congress

Treatment for older women with breast cancer – challenges and opportunities –an experience from Toronto Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada (#577)

Ewa F Szumacher 1 , Tamara Harth 1 , Margaret Fitch 1 , Maureen Trudeau 1 , Merrylee McGuffin 1 , Lisa Prospero 1 , Deb Feldman-Stewart 2
  1. Sunnybrook Health Sciences Centre , University of Toronto, Toronto, On, Canada M4N3M5, ON, Canada
  2. Oncology, Queens University, Kingston, Ontario, Canada


As the mean age of the global population increases, breast cancer in older women will be increasingly encountered in clinical practice


To present the needs, decisional support and development of a patient decision-aid (PtDA) for women 70 years and older post lumpectomy with early stage breast cancer


Focus groups, one-on-one patient interviews and a survey were conducted. Patients’ decision aid was developed. Measures included patients' satisfaction with the PtDA, self-reported decisional conflict, and level of distress, treatment-related knowledge, and choice predisposition


Sixteen women participated in focus groups, age 76 (range: 70 to 84), and ninety-two, 60 years and older participated in the survey .The majority of women received adequate decisional support during their cancer journey. No significant differences in overall decisional support based on age at diagnosis, education level, ethnicity or the presence of co morbidities. Participants desired educational resources such as a worksheet, consultation summary, or workbook to assist in making a treatment decision. The PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], -7.18; 95% confidence interval [CI], -13.50 to 12.59); increased clarity of the benefits and risks (AMD, -10.86; CI, -20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88-10.28) after using the PtDA. General trends were also reported in the patients' choice predisposition scores that suggested potential differences in treatment decision after PtDA use


Our studies showed that treatments for older women with breast cancer should be tailored according to their needs. Our group is working towards development of a multidisciplinary clinical program for frail women with breast cancer. The results of our studies will be presented at the congress