Breast cancer surgery in elderly patients: a local audit
Association of Breast Surgery ePoster Library. Shakir T. 05/15/17; 166207; P151
Dr. Taner Shakir
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Abstract
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Introduction
The management of breast cancer in the elderly varies greatly. We evaluated our practice in this retrospective audit.
Methods
All cancers diagnosed in patients aged 75 or over between January 2011 and December 2015 were included. Medical notes and histo-pathological reports were studied for data collection.
Results
Three hundred and sixty-six patients (4 males) were identified. Mean age of diagnosis was 83 years old (75 – 102). The average number of co-morbidities was 2.7 (0-10). Median follow-up was 32 months (0-70).
One hundred and fifty-eight (43%) patients received primary endocrine therapy. Of these, 37 patients declined surgery even though they were deemed fit. Seven patients were palliated. A total of 201 (55%) patients underwent surgery as first-line treatment.
Ninety-eight patients underwent breast conserving surgery (BCS). One hundred and three patients had mastectomy, of which 4 were reconstructed. Ninety-one patients received radiotherapy post BCS. Three local recurrences were noted.
The overall complication rate was 10%. There were 8 haematoma, 5 cellulitis, 2 wound dehiscence, 2 skin necrosis, 1 abscess, 1 iatrogenic skin burn and 1 patient developed ischaemic colitis. One patient returned to theatre for wound debridement.
Conclusions
Surgery was performed in patients with fewer co-morbidities (2.4 vs 3.1 endocrine). Both mastectomy and BCS groups have similar co-morbidities and survival outcome, but complication rate is higher in the mastectomy group. Patients who underwent surgery seemed to have an increased length of survival. Designated pathways and joint-care between surgeons and specialist physicians should ensure appropriate patient selection and optimise post-operative care.
The management of breast cancer in the elderly varies greatly. We evaluated our practice in this retrospective audit.
Methods
All cancers diagnosed in patients aged 75 or over between January 2011 and December 2015 were included. Medical notes and histo-pathological reports were studied for data collection.
Results
Three hundred and sixty-six patients (4 males) were identified. Mean age of diagnosis was 83 years old (75 – 102). The average number of co-morbidities was 2.7 (0-10). Median follow-up was 32 months (0-70).
One hundred and fifty-eight (43%) patients received primary endocrine therapy. Of these, 37 patients declined surgery even though they were deemed fit. Seven patients were palliated. A total of 201 (55%) patients underwent surgery as first-line treatment.
Ninety-eight patients underwent breast conserving surgery (BCS). One hundred and three patients had mastectomy, of which 4 were reconstructed. Ninety-one patients received radiotherapy post BCS. Three local recurrences were noted.
The overall complication rate was 10%. There were 8 haematoma, 5 cellulitis, 2 wound dehiscence, 2 skin necrosis, 1 abscess, 1 iatrogenic skin burn and 1 patient developed ischaemic colitis. One patient returned to theatre for wound debridement.
Conclusions
Surgery was performed in patients with fewer co-morbidities (2.4 vs 3.1 endocrine). Both mastectomy and BCS groups have similar co-morbidities and survival outcome, but complication rate is higher in the mastectomy group. Patients who underwent surgery seemed to have an increased length of survival. Designated pathways and joint-care between surgeons and specialist physicians should ensure appropriate patient selection and optimise post-operative care.
Introduction
The management of breast cancer in the elderly varies greatly. We evaluated our practice in this retrospective audit.
Methods
All cancers diagnosed in patients aged 75 or over between January 2011 and December 2015 were included. Medical notes and histo-pathological reports were studied for data collection.
Results
Three hundred and sixty-six patients (4 males) were identified. Mean age of diagnosis was 83 years old (75 – 102). The average number of co-morbidities was 2.7 (0-10). Median follow-up was 32 months (0-70).
One hundred and fifty-eight (43%) patients received primary endocrine therapy. Of these, 37 patients declined surgery even though they were deemed fit. Seven patients were palliated. A total of 201 (55%) patients underwent surgery as first-line treatment.
Ninety-eight patients underwent breast conserving surgery (BCS). One hundred and three patients had mastectomy, of which 4 were reconstructed. Ninety-one patients received radiotherapy post BCS. Three local recurrences were noted.
The overall complication rate was 10%. There were 8 haematoma, 5 cellulitis, 2 wound dehiscence, 2 skin necrosis, 1 abscess, 1 iatrogenic skin burn and 1 patient developed ischaemic colitis. One patient returned to theatre for wound debridement.
Conclusions
Surgery was performed in patients with fewer co-morbidities (2.4 vs 3.1 endocrine). Both mastectomy and BCS groups have similar co-morbidities and survival outcome, but complication rate is higher in the mastectomy group. Patients who underwent surgery seemed to have an increased length of survival. Designated pathways and joint-care between surgeons and specialist physicians should ensure appropriate patient selection and optimise post-operative care.
The management of breast cancer in the elderly varies greatly. We evaluated our practice in this retrospective audit.
Methods
All cancers diagnosed in patients aged 75 or over between January 2011 and December 2015 were included. Medical notes and histo-pathological reports were studied for data collection.
Results
Three hundred and sixty-six patients (4 males) were identified. Mean age of diagnosis was 83 years old (75 – 102). The average number of co-morbidities was 2.7 (0-10). Median follow-up was 32 months (0-70).
One hundred and fifty-eight (43%) patients received primary endocrine therapy. Of these, 37 patients declined surgery even though they were deemed fit. Seven patients were palliated. A total of 201 (55%) patients underwent surgery as first-line treatment.
Ninety-eight patients underwent breast conserving surgery (BCS). One hundred and three patients had mastectomy, of which 4 were reconstructed. Ninety-one patients received radiotherapy post BCS. Three local recurrences were noted.
The overall complication rate was 10%. There were 8 haematoma, 5 cellulitis, 2 wound dehiscence, 2 skin necrosis, 1 abscess, 1 iatrogenic skin burn and 1 patient developed ischaemic colitis. One patient returned to theatre for wound debridement.
Conclusions
Surgery was performed in patients with fewer co-morbidities (2.4 vs 3.1 endocrine). Both mastectomy and BCS groups have similar co-morbidities and survival outcome, but complication rate is higher in the mastectomy group. Patients who underwent surgery seemed to have an increased length of survival. Designated pathways and joint-care between surgeons and specialist physicians should ensure appropriate patient selection and optimise post-operative care.
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