HealthDay News — Breast cancer surgery is safe in women 70 years and older, according to a study published in the British Journal of Surgery.
Jenna L. Morgan, MD, from the University of Sheffield in the United Kingdom, and colleagues sought to understand factors influencing treatment selection and outcomes from surgery for older patients with breast cancer. The analysis included 3375 women (aged ≥70 years) with operable breast cancer seen at 57 UK breast units between 2013 and 2018.
The researchers found that 2816 patients underwent surgery, including mastectomy in 1138 procedures and breast-conserving surgery in 1716 procedures. Additionally, there were 575 axillary lymph node dissections and 2203 sentinel node biopsies. Predictors of mastectomy included age (multivariable odds ratio [OR] for age, 1.06), frailty, dementia, and comorbidities. Similarly, age, frailty, and comorbidity were significant predictors of no axillary surgery (OR for age, 0.91). There was a moderate rate of adverse events (551 of 2854; 19.3%), but there was no 30-day mortality. Surgery adversely affected long-term quality of life and functional independence.
“Surgeons select out the least fit women for primary endocrine therapy and undoubtedly if we operated on ‘all comers’ we would see more adverse outcomes,” Morgan said in a statement. “The issue is to know where to set the selection threshold for optimal outcomes.”