Age ≥75 + ECOG ≥2 + significant comorbidity — anthracycline + dose-dense regimens poorly...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-BREAST-FRAILTY-AGE`
Type	Red flag
Status	pending_clinical_signoff
Diseases	`DIS-BREAST`
Sources	`SRC-ESMO-BREAST-EARLY-2024` `SRC-NCCN-BREAST-2025`

Red Flag Origin

Definition	Age ≥75 + ECOG ≥2 + significant comorbidity — anthracycline + dose-dense regimens poorly tolerated; consider TC, weekly paclitaxel, single-agent endocrine, or trastuzumab + chemo of reduced intensity.
Clinical direction	de-escalate
Category	frailty-age

Trigger Logic

{
  "all_of": [
    {
      "comparator": ">=",
      "finding": "age_years",
      "threshold": 75
    },
    {
      "any_of": [
        {
          "comparator": ">=",
          "finding": "ecog_status",
          "threshold": 2
        },
        {
          "comparator": ">=",
          "finding": "comorbidity_count",
          "threshold": 2
        }
      ]
    }
  ],
  "type": "composite_clinical"
}

Notes

Geriatric assessment (G8 / CGA) recommended pre-treatment for ≥70. HR+ disease in frail elderly may be managed with endocrine therapy alone (favorable risk-benefit). HER2+: trastuzumab + paclitaxel weekly or T-DM1 monotherapy alternatives. TNBC: weekly paclitaxel or capecitabine.

Used By

Indications

IND-BREAST-HER2-POS-EARLY-NEOADJUVANT - IND-BREAST-HER2-POS-EARLY-NEOADJUVANT
IND-BREAST-TNBC-EARLY-NEOADJUVANT - IND-BREAST-TNBC-EARLY-NEOADJUVANT