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.

中文翻译：

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渡过难关：管理在COVID-19及以后的老年乳腺癌患者

由于先前存在和竞争性合并症，治疗相关毒性的潜力以及对功能状态的影响，对老年乳腺癌患者的护理提出了独特的临床考虑。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，并鼓励我们重新调整治疗重点。在努力避免治疗延迟并保持治疗益处的同时，我们还需要将严重急性呼吸综合征冠状病毒2（SARS-CoV-2）暴露，骨髓抑制，一般化学疗法毒性和功能下降的风险降至最低。在此，我们提出了针对老年乳腺癌患者的多学科护理注意事项，目的是促进以团队为基础，在COVID-19大流行及以后期间采取多学科治疗方法。在我们为每年在美国诊断出的70岁及以上的乳腺癌患者中，约有30％以及成千上万患有复发和/或转移性疾病的老年患者中，我们在“新常态”下导航时，这些考虑仍然是相关的。