Fitness Assessments Should Be Integrated Into Care for Older Patients With Breast Cancer

Brittany Lovely
Published: Monday, Aug 26, 2019
Armin Shahrokni, MD, MPH

Armin Shahrokni, MD, MPH

Treatment decisions for older patients with breast cancer should be individualized based on the fitness and frailty of the patient, making the use of geriatric assessment tools an essential element of care, according to Armin Shahrokni, MD, MPH.

“As geriatricians, we spend 60 minutes or more with patients to assess their functional status, comorbidities, nutrition, mood, pharmacy, the place they live, their social support, and their cognition,” Shahrokni said. “You may think this is too much, but some of these things you are already doing in your clinic.”

Figure. Risk Score (A) Versus Physician-Rated Karnofsky Performance Status (B) to Predict Grades 3-5 Chemotherapy Toxicity4

Figure. Risk Score (A) Versus Physician-Rated Karnofsky Performance Status ( B ) to Predict Grades 3-5 Chemotherapy Toxicity4 The Cancer and Aging Research Group brief geriatric assessment scale is designed to obtain specific estimates on the risk of chemotherapy toxicity. The predictive tool allows patients to complete a 20-to-30-minute self-assessment that includes activities of daily life, instrumental activities of daily life, number of falls in the prior 6 months, number and type of comorbid conditions, number of medications, vision and hearing assessment, social activity limitation measures, social support assessment, and a section to report any unintentional weight loss in the prior 6 months.
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