Serious adverse events in those 70 years and older found to be rare
WEDNESDAY, June 10, 2020 (HealthDay News) — Breast cancer surgery is safe in women 70 years and older, according to a study published online June 2 in the British Journal of Surgery.
Jenna L. Morgan, M.D., 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 3,375 women (aged ≥70 years) with operable breast cancer seen at 57 U.K. breast units between 2013 and 2018.
The researchers found that 2,816 patients underwent surgery, including mastectomy in 1,138 procedures and breast-conserving surgery in 1,716 procedures. Additionally, there were 575 axillary lymph node dissections and 2,203 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 2,854; 19.3 percent), 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.”
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