# Advocate-BREAST80+: A Comprehensive Patient and Advocate-Led Study to Enhance Breast Cancer Care Delivery and Patient-Centered Research in Women Aged ≥80 Years

## TL;DR

This study explores the unique needs of breast cancer patients aged 80 and older, finding they are less satisfied with treatment information and less likely to join clinical trials.

## Contribution

The study introduces a patient-led initiative focusing on improving care and research participation for breast cancer patients aged ≥80 years.

## Key findings

- Older breast cancer patients were less satisfied with information about treatment side effects and their management.
- Patients aged ≥80 years were significantly less likely to participate in clinical trials or express interest in future participation.
- Despite lower anxiety, older patients had unmet educational needs and faced barriers to research involvement.

## Abstract

The high-level aims of the Advocate-BREAST initiative are to study and improve the overall experience of patients with breast cancer (BC) through education, shared decision making, and patient-centered clinical trials. Advocate-BREAST80+ is a survey substudy that specifically focused on the unique needs and perspectives of BC patients aged ≥80 years. Although patients aged ≥80 years experienced less anxiety and symptom-related distress compared with younger patients, they were significantly less satisfied with information regarding short and long term side effects of BC therapies, as well as the management of same. Older patients were significantly less likely to have participated in a clinical trial or be open to considering this option in future. Future research should address unique educational needs and barriers to research participation in older BC patients. Focused interviews could assist with better comprehension of the lived experience of these patients, given the smaller number of BC patients ≥80 years in many available databases.

Background: There are limited evidence-based data to guide treatment recommendations for breast cancer (BC) patients ≥80 years (P80+). Identifying and addressing unmet needs are critical. Aims: Advocate-BREAST80+ compared the needs of P80+ vs. patients < 80 years (P80−). Methods: In 12/2021, a REDCap survey was electronically circulated to 6918 persons enrolled in the Mayo Clinic Breast Disease Registry. The survey asked about concerns and satisfaction with multiple aspects of BC care. Results: Overall, 2437 participants responded (35% response rate); 202 (8.3%) were P80+. P80+ were less likely to undergo local regional and systemic therapies vs. P80− (p < 0.01). Notably, P80+ were significantly less satisfied with information about the short and long-term side effects of BC therapies and managing toxicities. P80+ were also less likely to have participated in a clinical trial (p < 0.001) or to want to do so in the future (p = 0.0001). Conclusions: Although P80+ experienced less anxiety and symptom-related distress compared with P80−, they were significantly less satisfied with information regarding the side effects of BC therapies and their management. P80+ were significantly less likely to have participated in a clinical trial or be open to considering this option. Future studies should address educational needs pertaining to side effects and barriers to research participation in P80+.