The aim of the study was to investigate the operative mortality and age-related trends in surgical management of breast cancer in the elderly. A total of 5235 patients underwent surgery for breast cancer (1994-2007) during this time. 42% were older than 60 years old, and 20% were older than 70 years old. Patient’s age ranged from 20 to 94 years old. 85% of patients were diagnosed with stage I and II disease, whereas 15% had advanced stage III and IV disease. The mean tumour size was 2 cm for those with invasive carcinoma, and 1.12 cm for those with DCIS. Patients over the age of 70 were more likely to have earlier stage (T1 and T2) tumour (92% vs 87%, p<0.01), smaller tumours (1.6cm vs 1.9cm, p<0.01), lower prevalence of Lymphovascular invasion (27% vs 36%, p<0.01), and lower prevalence of a positive sentinel lymph node (26% vs 31%, p=0.01). There were also higher prevalence of invasive lobular carcinomas in the elderly (12% vs 7%, p<0.01). 65% of patients over 70 years old underwent breast conserving surgery (BCS), which was not significantly different to BCS rate of 62% in those under 70 years old (p=0.16). Bilateral mastectomy rates were significantly higher in those under 70 years old (31% vs. 13%, p<0.01). Analysis of mortality after surgical procedure was performed on day 30 and 90. 30 day mortality for patients over 70 years old was 0.2%. No patients died after 30 days in those under 70 years old. The 90 day mortality for patients over 70 years old was 0.7%, compared to 0.05% for those less than 70 years old.
The Breast Journal 2012, DOI: 10.1111/j.1524-4741.2012.01272.x
OnSurg thanks the editors at School of Surgery for making their current surgical literature summaries available to the world. School of Surgery tweets at @schoolofsurgery and maintains a Facebook fan page here.