Outcomes after Mastectomy and Lumpectomy in Octogenarians and Nonagenarians with Early-Stage Breast Cancer

Abstract

Prospective studies have shown equal outcomes after mastectomy or breast conservation in patients with invasive breast cancer; however, many of these studies excluded elderly patients. We identified patients in their eighties and nineties with clinical stage 0 to II breast cancer undergoing mastectomy or lumpectomy with or without radiation from the prospective sentinel lymph node database at Wake Forest Baptist Health and analyzed their treatment and survival. Of 92 patients, 24 (26.1%) underwent mastectomy, 22 (23.9%) lumpectomy with radiation, and 46 (50.0%) lumpectomy alone. Significant differences were noted in tumor size (P = 0.018), nodal status (P = 0.013), and stage (P = 0.011) between the groups. Only 7.6 per cent of patients had chemotherapy, whereas 51.1 per cent took antiestrogen therapy. Recurrence occurred in 11 patients. In univariate analysis, overall survival did not differ by surgery. Age was the only factor that increased risk of death (HR = 1.19, P = 0.028). In this age group, neither tumor factors nor the type of local treatment significantly influenced overall survival. Octogenarians and nonagenarians with early-stage breast cancer undergoing breast-conserving surgery with or without radiation have equivalent survival to patients having a mastectomy.

Receipt of Guideline-Concordant Care Among Older Women With Stage I–III Breast Cancer: A Population-Based Study

“…9,17,28 However, a recent study reported no significant difference in overall survival between octogenarians and nonagenarians who did and did not receive adjuvant treatments for early-stage breast cancer. 30 Therefore, the lower rates of GCC observed among the oldest age groups of women may be reasonable, considering individual patient circumstances. Moreover, because of functional status, quality of life, and life expectancy, oncologists often cite increasing age, with or without comorbidity, as the primary reason for use of less aggressive treatment.…”

Effects of a Hypnosis Session Before General Anesthesia on Postoperative Outcomes in Patients Who Underwent Minor Breast Cancer Surgery

“…Breast cancer is the most frequent cancer among women, with psychological, professional, and social effects. 1 , 2 Diagnosis and treatment, as well the consequences on womanhood and everyday life, are often harsh. In this “hostile” environment, most women undergo breast surgery, which can lead to even more stress.…”

“…Breast cancer is the most frequent cancer among women, with psychological, professional, and social effects . Diagnosis and treatment, as well the consequences on womanhood and everyday life, are often harsh.…”