Abstract 464P
Background
The frailty status of elderly Chinese breast cancer patients has not been fully assessed. The aim of this study was to assess the prevalence of frailty and pre-frailty and associated factors in elderly Chinese patients with breast cancer.
Methods
This is a prospective cross-sectional registry study. Breast cancer patients aged over 65 years were classified into robust (0 points), pre-frailty (1-2 points) and frailty (3-5 points) using the Frailty Screening Scale. The HADS, the sleep and pain subscale of the EORTC QLQ-C30 and the Charlson Comorbidity Index (CCI) were used to assess associated factors. Logistic regression model was used to analyse the factors related to frailty and pre-frailty.
Results
481 elderly breast cancer patients treated at our hospital from October 2021 to November 2022 were finally analysed. The median age was 69 years. 76.7% of patients were in early-stage. The proportions of patients receiving surgery, chemotherapy, radiotherapy and endocrine therapy were 91.1%, 56.5%, 30.1%, and 65.3%, respectively. 75 (15.6%) patients met the diagnostic criteria for frailty and 257 (53.4%) patients were in pre-frailty state. Multivariate logistic regression analysis showed that independently associated risk factors for frailty included advanced tumours, more comorbidities, anxiety, insomnia and pain (all P<0.05). The latter three factors were also independently associated with pre-frailty (all P<0.05). Age, BMI, molecular subtype (not shown) and treatment were not significantly associated with frailty and pre-frailty (all P>0.05) (Table). Table: 464P
Multivariable analysis
| Robust vs pre-frailty | Robust vs frailty | |||
| OR | P | OR | P | |
| Age | 0.98(0.94-1.03) | 0.51 | 1.00(0.92-1.09) | 0.98 |
| Stage | ||||
| Early | - | - | ||
| Advanced | 1.51(0.79-2.87) | 0.21 | 12.95(4.38-38.31) | <0.01 |
| Surgery | 1.31(0.57-2.99) | 0.53 | 2.02(0.51-8.09) | 0.32 |
| Chemotherapy | 0.93(0.56-1.52) | 0.76 | 0.59(0.26-1.36) | 0.22 |
| Radiotherapy | 0.79(0.47-1.33) | 0.38 | 0.68(0.27-1.69) | 0.40 |
| Endocrine therapy | 1.11(0.58-2.11) | 0.76 | 0.48(0.16-1.47) | 0.20 |
| CCI | 1.17(0.98-1.41) | 0.09 | 2.07(1.39-3.08) | <0.01 |
| Anxiety | 4.00(1.09-14.66) | 0.04 | 7.45(1.33-41.63) | 0.02 |
| Depression | 1.12(0.45-2.77) | 0.81 | 0.52(0.12-2.22) | 0.38 |
| Insomina | 1.01(1.00-1.02) | 0.01 | 1.02(1.00-1.03) | 0.01 |
| Pain | 1.02(1.01-1.03) | 0.01 | 1.03(1.01-1.05) | <0.01 |
Conclusions
Frailty is not prevalent in elderly breast cancer, but most of them are in a pre-frailty state. Before making clinical decisions for these patients, it is necessary to evaluate the associated factors and to make appropriate interventions for controllable factors (such as anxiety, insomnia, comorbidities, etc.) to improve patients' tolerance and compliance with tumour treatment.
Clinical trial identification
Editorial acknowledgement
This research was funded by Medical Oncology Key Fundation of Cancer Hospital Chinese Academy of Medical Sciences (grant number CICAMS-MOMP2022007) and National Key R&D Program of China (grant number 2020YFC2004803).
Legal entity responsible for the study
P. Zhang.
Funding
Medical Oncology Key Fundation of Cancer Hospital Chinese Academy of Medical Sciences (grant number CICAMS-MOMP2022007) and National Key R&D Program of China (grant number 2020YFC2004803).
Disclosure
All authors have declared no conflicts of interest.
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