Weathering the Storm: Managing Older Adults with Breast Cancer Amid COVID-19 and Beyond

J Natl Cancer Inst. 2020 May 25;djaa079. doi: 10.1093/jnci/djaa079. Online ahead of print.

Abstract

Caring for older patients with breast cancer presents unique clinical considerations due to 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 re-focus 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 age ≥70 years who are diagnosed in the U.S. annually and for the thousands of older patients living with recurrent and/or metastatic disease.

Keywords: COVID-19; breast cancer; elderly; older patients.