Many older women diagnosed with nonmetastatic breast cancer may experience functional decline or death within 12 months of breast cancer treatment initiation, but the Vulnerable Elders Survey (VES-12) may help to identify those most at risk, according to a study recently published in Cancer.
The functional status of patients with cancer has been shown to be a key indicator of not only their ability to tolerate treatment, but also overall health outcomes. As such, preventing function decline could provide a number of benefits for patients and providers, including the identification of the most vulnerable patients.
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Therefore, researchers led by Cynthia Owusu, MD, MS, University Hospitals Seidman Cancer Center (Cleveland, OH), conducted a study to determine whether the VES-13, a 13-item self-administered test, could be used to accurately predict the functional decline and death of women 65 years and older with newly diagnosed stage I to III breast cancer.
For the study, researchers enrolled more than 200 patients from ambulatory oncology clinics at an academic center between April 2008 and April 2013. The VES-13 was completed prior to the initiation of neoadjuvant or adjuvant treatment and the primary outcome of the study was function decline or death, as defined by a decrease of at least 1 point on the Activities of Daily Living scale or the Instrumental Activities of Daily Living scale, or death between baseline and 12 months (yes or no).
After 12 months of follow-up, a total of 184 patients were available for analysis, 22% of whom died (n=7) or experienced functional decline (n=34). The most significant correlates of functional decline or death were a higher VES-13 score and having a high school education or less.
Thus, researchers concluded that the VES-13 was a useful instrument for the early identification of elderly women with newly diagnosed nonmetastatic breast cancer at risk of functional decline or death.
“This instrument offers the opportunity for early identification and will inform the development of interventions to prevent and address functional decline for those particularly at risk, such as women with low socioeconomic status," said Dr. Owusu in a press release. "Such efforts may in the long term translate to improved treatment tolerance and better breast cancer outcomes."
