Improving the Approach to and Management of the Older Metastatic Breast Cancer Patient

Older oncology patients pose a significant treatment challenge due to poor chemotherapy
tolerance as a result of underlying co-morbidities, lack of social support, and diminished
functional reserve. Oncologists are faced with the challenge of differentiating between
patients that can and cannot tolerate chemotherapy, and tailoring therapy to the patient's
biologic rather than chronologic age.

A significant challenge that surrounds the treatment of the older metastatic breast cancer
(MBC) patient in particular, lies in the lack of evidence based clinical data to guide the
oncologist in determination of a treatment plan. This is a result of under representation of
older patients in clinical trials. Due to these challenges a thorough evaluation of the
older patient is recommended prior to initiation of anti-cancer therapy.

The purpose of this research study is to enhance the care of the older MBC patient by
increasing awareness among oncology providers as to the unique aspects of care required for
older patients. The goal of the study is to educate providers on the utility of geriatric
assessment in guiding therapy of older metastatic breast cancer patients. The investigators
will also assess the feasibility and benefit of incorporating geriatric self-assessments
into clinical practice. The study will include three phases:

1. Needs assessments - to understand the population of older metastatic breast cancer
patients seen in routine practice at community centers, and assess their treatment
approach.

2. Educational programming about management of older metastatic breast cancer patients,
and geriatric assessment of these patients.

3. Active testing of the use of geriatric assessment in clinical practice.

The ultimate goal is to develop an educational curriculum that could be implemented at other
community oncology sites beyond the participants on this study. This type of educational
intervention can be applied to other disease sites in the future. During the study period we
will identify the specific gaps that exist in each practice and develop an educational
intervention to match these gaps. Our hope is that all involved practices will benefit from
incorporating a geriatric assessment into their practice and will find it feasible to use
the tools provided. These data are of high importance to the oncologic community and would
be hypothesis-generating for future clinical trials.

Inclusion Criteria:

- Evidence of metastatic breast cancer (MBC)

- Ongoing active therapy for MBC

- Ability to sign informed consent, and complete a self-assessment evaluation.

- Life expectancy >3 months

Exclusion Criteria:

- No evidence of MBC

- Inability to read and understand English

- Not on active therapy