Implementation of the first oncogeriatric subunit for breast cancer patients in Poland: rationale, pilot results and perspectives

Introduction. Older women constitute a growing proportion of breast cancer patients, yet their care often remains fragmented and insufficiently adapted to functional status. To address this gap, the first onco-geriatric unit in Poland was established within a comprehensive breast cancer center. Material and methods. The ONKOger model integrates routine Comprehensive Geriatric Assessment (CGA), cardio-oncology consultation, and multidisciplinary treatment planning. A pilot phase was conducted in women aged ≥ 75 years, assessing feasibility, geriatric impairments and the impact on treatment decisions. Results. Among 832 patients evaluated, 138 (16.6%) were aged ≥ 75 years, 109 (79%) screened positive for vulnerability (VES-13 ≥ 3). CGA frequently identified multimorbidity, polypharmacy, functional decline and unmet social needs. Treatment plans were modified in a substantial proportion, including dose adjustments, simplified systemic therapy and enhanced supportive care. Conclusions. The ONKOger model is feasible, clinically relevant and supports individualized treatment and safer care pathways for older breast cancer patients. It may serve as a foundation for developing structured oncogeriatric services in Poland.