Abstract PS5-04-23: Patient priorities for breast cancer survivorship: a preliminary descriptive analysis of the health outcome goals that matter most to older adults breast cancer survivors

Abstract Introduction: Older adult breast cancer survivors have an average of five chronic conditions, and frequently report worse physical functioning, greater fatigue, and emotional distress, which hinders their ability to perform activities of daily living and achieve whole-person, often function-oriented goals during survivorship care. The Patient Priorities Care (PPC) framework was initially developed on a cohort of older adult cancer survivors and offers a structured approach to: 1) elicit patients’ goals, and 2) align survivorship care with what matters most. Despite evidence that reduces treatment burden in patients with multiple chronic conditions, its application in breast cancer survivorship remains underexplored. Objective: To describe older adults' goals for breast cancer survivorship care based on preliminary findings from a quality improvement initiative aimed at identifying older adult cancer survivors’ care priorities and aligning survivorship care using the Patient Priorities Care (PPC) framework. Methods: We conducted a randomized quality improvement project focused on older adults (≥65 years) with early stage breast cancer, post active cancer therapy (3 months after curative treatment and up to 10 years in their survivorship care) with evidence of burdensome care (having ≥ 3 comorbidities or taking ≥10 medications or seeing more than ≥specialists per year or having ≥ 2 emergency department/hospital visits per year). Using the PPC framework, with the help of a trained facilitator, the participants identified their care preferences and health outcomes goals, as well as barriers (symptoms, medical problems) that were in the way of achieving their goals. Interviews were conducted via telephone or the Teams online platform. A summary of the health priorities identification encounter was provided to the oncology team to use for further care alignment. Demographic data was gathered at baseline and evaluated through frequentist statistical methods. Goal attainment scaling was done at baseline and 3 months following the National Committee for Quality Assurance (NCQA) guidelines. Results: Since January 2025, a total of 32 patients have been enrolled, with a mean age of 73 years. The majority of participants (40%) were diagnosed with stage I breast cancer, followed by ductal carcinoma in situ (18%), stage II (31%), and stage III (9.3%). Regarding treatment received, 97% of patients underwent surgery, 81% received radiation therapy, and 78% received systemic treatment, including hormonal therapy (37.5%), neoadjuvant therapy (6%), and 6% adjuvant therapy (6%). Sixty percent of the patients reported that functional status and maintaining independence were their priority for survivorship care, leading participants to establish goals centered around these themes. Factors influencing goal-setting included physical function, social support, and the presence of chronic comorbidities. Among the 10 patients who reached the 3-month follow-up time point, 9 patients had successfully achieved their stated goal within that timeframe. Conclusions: Preliminary findings suggest that older adult cancer survivors value survivorship care that supports functional goals. The PPC framework may be a useful tool to guide individualized breast cancer survivorship planning and promote goal-concordant care. Future work should explore how these priorities evolve over time and influence decision-making. This project is supported through a K12 NIH Institutional Grant (5K12TR004908-02) and by NIA through a GEMSSTAR (1R03AG089057-01). Citation Format: D. E. Giza, A. Gonzalez, I. Doostan, B. Basbayraktar, A. Mera, G. Yalavarthy, V. Kaklamani, J. A. Barrera, M. Karuturi, S. Ghosh, H. Holmes, A. Naik. Patient priorities for breast cancer survivorship: a preliminary descriptive analysis of the health outcome goals that matter most to older adults breast cancer survivors abstract. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS5-04-23.