A number of factors should be considered at this stage:

• the patient’s overall condition, life expectancy, decision-making capacity and results from a geriatric assessment if appropriate in those over the age of 70 years
• patient preferences and aims of treatment
• psychosocial screening/evaluation and support
• discussing the multidisciplinary team approach to care with the patient
• ensuring a breast care nurse is part of the multidisciplinary team
• appropriate and timely referral to an MDM
• considering if an interpreter is required
• pregnancy and fertility options, contraception and prevention of chemotherapy-induced menopause
• financial and social aspects
• support with travel and accommodation
• teleconferencing or videoconferencing as required.