INFLUENCE OF GERIATRIC ASSESSMENT ON TREATMENT DECISIONS IN ELDERLY BREAST CANCER PATIENTS ambrogio.londero@gmail.com

3103-05

INFLUENCE OF GERIATRIC ASSESSMENT ON TREATMENT DECISIONS IN ELDERLY BREAST CANCER PATIENTS

7

Italy

Oral or Poster

In older women diagnosed with breast cancer (BC), treatment decisions should consider tumor characteristics alongside patients' functional reserve, frailty, risk of falls, and psychological distress, in order to prevent under- or overtreatment. This study aims to assess the impact of G8 Geriatric Screening Tool on surgical and adjuvant treatment decisions for women ≥70.

Our retrospective cohort study involved 129 patients ≥70 treated for BC in 2024. Each patient was assessed using Katz Activities of Daily Living (ADL) scale, Norton Scale, G8 screening tool, distress thermometer, and Conley fall-risk assessment.

Median age was 76 years (IQR 73–82). 93% of patients underwent breast surgery (36.4% mastectomy and 56.6% breast-conserving surgery). 14.7% were treated with neoadjuvant therapy. Adjuvant radiotherapy was provided to 55.0% of patients, chemotherapy to 20.2%, and hormonal treatment to 72.1%. 65 patients (50.4%) were classified as frail, and exhibited a significantly higher median age (81 vs 74 years, p<0.05) a lower median BMI (23 kg/m² vs 27 kg/m², p<0.05), a higher likelihood of forgoing breast surgery entirely (12.3% vs 1.6%, p<0.05), a lower probability of undergoing axillary clearance (p=0.108) and adjuvant hormonal therapy (56.9% vs. 87.3%, p<0.05). The lack of a family caregiver correlated with an increased propensity to forgo surgery.

Frailty, as assessed by G8, is significantly associated with the omission of surgical interventions and hormonal therapy in elderly BC patients, irrespective of tumor stage. Systematic geriatric assessments can identify high-risk patients who may benefit from tailored, multidisciplinary management strategies to optimize outcomes.