Interdisciplinarity care through the establishment of an institutional frailty assessment protocol: clinical characteristics of patients with breast cancer treated in an outpatient unit

Keywords

breast cancer - interdisciplinarity - oncological frailty risk

Background: There is a growing emphasis on the application of interdisciplinarity approaches in the treatment of breast cancer, especially for patients with some degree of frailty that interferes with therapeutic implementation. Although the studies have limitations due to different methodologies, they reinforce the importance of collaborative teams in individualized and humanized patient care.

Objective: To identify the clinical characteristics of breast cancer patients assessed by the interdisciplinarity team through the institutional therapeutic oncological frailty risk protocol.

Method: Observational Retrospective Cohort Study involved 190 patients diagnosed with breast cancer between January and December 2023, treated at a Brazilian oncology health service. Demographic data, staging and treatment intention were collected from records. Descriptive analysis of the study population was carried out by determining central tendency and dispersion measures for continuous variables and frequency distribution for categorical variables. The therapeutic oncology fragility risk was assessed using an institutional protocol that used the tools of subjective Patient-Produced Global Assessment (reduced ASG-PPP) plus strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F), Hospital Anxiety and Depression Scale (HADS), pharmaceutical questionnaire on essential medications and assessment of the need for portacath, respectively by the nutrition, psychology, pharmacy and nursing sectors, where each analysis could receive a score 0 (no risk) or 1 (with risk). The sum of the scores provided a frailty risk score, with up to 2 being considered low risk and > 2 being high risk. All sectors monitored high-risk patients together; low-risk patients were monitored as needed.

Results: Of the 190 patients, two were male. 68.4% were aged ≥ 50 years, and 62.8% were overweight. The majority of patients (64.5%) had stages I and II. Twenty patients were undergoing palliative treatment. 82.7% of stage III and IV patients obtained a low-risk score.

Conclusion: Interestingly, the study demonstrated that our interdisciplinarity institutional protocol for assessing the risk of therapeutic oncology frailty did not reveal that advanced/metastatic clinical staging was a variable that directly correlated with a frailty risk score in daily practice. It strengthened the use of pre-established standard metrics for the integrative assessment of these patients.

Corresponding author: Sabrina Cristofaro Maciel Pereira (e-mail: [e-mail]).

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
06 May 2025