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. 2022 Mar 4;27(2):e133-e141.
doi: 10.1093/oncolo/oyab032.

Prospective Comparison of Geriatric Assessment and Provider's Assessment of Older Adults With Metastatic Breast Cancer in the Community

Rino S Seedor  1 , Caitlin R Meeker  2 , Bianca Lewis  2 , Elizabeth A Handorf  3 , Kelly A Filchner  2 , Ramya Varadarajan  4 , Jack Hensold  5 , Aruna Padmanabhan  6 , Benjamin Negin  7 , Kenneth Blankstein  8 , Neha R Chawla  9 , Wei Frank Song  10 , Jessica Epstein  2 , Jennifer Winn  11 , Lori J Goldstein  11 , Efrat Dotan  11
Affiliations

Prospective Comparison of Geriatric Assessment and Provider's Assessment of Older Adults With Metastatic Breast Cancer in the Community

Rino S Seedor et al. Oncologist. .

Abstract

Background: Geriatric assessment (GA) is recommended for evaluating fitness of an older adult with cancer. Our objective was to prospectively evaluate the gaps that exist in the assessment of older adults with metastatic breast cancer (OA-MBC) in community practices (CP).

Methods: Self-administered GA was compared to provider's assessment (PA) of patients living with MBC aged ≥65 years treated in CP Providers were blinded to the GA results until PA was completed. McNemar's test was used to detect differences between PA and GA.

Results: One hundred patients were enrolled across 9 CP (median age 73.9). Geriatric assessment detected a total of 356 abnormalities in 96 patients; of which, 223 required interventions. African American and widowed/single patients were more likely to have abnormalities identified by GA. On average, across 100 patients, PA did not detect 25.5% of GA-detected abnormalities, mostly in functional status, social support, nutrition, and cognition. These differences were less pronounced among providers with more clinical experience. Patients with abnormal Timed Up and Go tests more likely had additional abnormalities in other domains, and more abnormalities that were not identified by PA. Providers were "surprised" by GA results in 33% of cases, mainly with cognitive or social support findings, and reported plans for management change for 39% of patients based on GA findings.

Conclusions: Including a GA in the care of OA-MBC in CP is beneficial for the detection of multiple abnormalities not detected by routine PA.

Keywords: breast cancer; clinical oncology; elderly; geriatric assessment; geriatrics.

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Figures

Figure 1.
Figure 1.
Longitudinal schema of educational intervention.
Figure 2.
Figure 2.
Breakdown of interventions detected on a geriatric assessment by “suggested” and “required” interventions.
Figure 3.
Figure 3.
Comparison of abnormalities found by provider’s assessments (PA) and geriatric assessments (GA) in the various geriatric domains.
See this image and copyright information in PMC

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