Background: Cancer strikes people of every age; however, older people have the highest risk, and as America’s population ages, the challenges uniquely impacting older women with breast cancer increase as well. Method and goals: With this in mind, SHARE conducted a survey of 1,000 women online from February - April 2021. We surveyed women in four age groups: 59 and younger, 60 -69, 70 -79, and 80 and above. On average, the women surveyed had been diagnosed with breast cancer within the last five years. The survey included 45 questions and was designed to identify how decisions are made, where support is given, and what women believe is still needed to foster a deeper sense of trust in their medical providers. Most importantly, we wanted to uncover what impact, if any, age has on how women answer these questions. The results: SHARE’s survey asked women to report on those factors most influential to their treatment decisions at the time of diagnosis. The five key considerations included: 1) time to consider all available treatment options (older women were more likely - 37% vs 22%- to state that they did not have enough time to consider treatment options); 2) discussions of emotional and mental well being and resources for support (older patients were more likely to have discussed mental health with their provider - 55% to 33%); 3) the inclusion of patient allies in decision making (older patients were more likely to seek out a cancer support helpline - 20% vs 7%); 4) the access to additional support resources (respondents younger than age 70 cited medical and health websites, cancer organizations and other medical professionals as their go-to resources, while those ages 70 to 79 were more likely to reach out to family, at 40%, before utilizing other resources); 5) the role of shared decision making (63% of respondents, ages 80 and older, report that their doctor made most of their treatment decisions, more than twice the rate of any other age group: ages 59 and younger, 31%; ages 60 to 69, 28%t; ages 70 to 79, 33%.). The survey also uncovered interesting information on the role of trust in the medical team (particularly across racial and ethnic, as well age cohorts), prevention and screening practices, financial concerns and insurance status, and clinical trials. Older patients were found to have less trust in their medical team, and stated that being given printed materials would have given them greater trust. Overall, it showed that 40% - 50% of older patients believe that their age influenced the following “a great deal” or “a lot”: their treatment plan (48%); how their healthcare team treated them as a person (45%), and how their healthcare team communicated with them (38%). Conclusion: Older breast cancer patients have a unique set of needs and perceptions, and open discussions about the impact of age, as well as attention to types of support, timing and decision making, are key when engaging with the older woman with breast cancer.

Citation Format: Carol Evans, Christine Benjamin, Joanne C Ryan, Katrina M Johnson, Gwen Mayes. More than a disease: Older women and breast cancer treatment [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P5-14-19.