Surgery for breast cancer in the elderly--how relevant?
Studies suggest that elderly women receive less aggressive treatment, experience higher disease progression and mortality from breast cancer. We report on an experience of 256 consecutive cases of symptomatic breast cancer in a population of over 75 years of age. 142/256 patients underwent surgical intervention in the form of breast conserving surgery or mastectomy, 114/256 did not. Mean follow up was 6.4 years. Our results show a statistically significant association between surgery and survival (p = 0.05, CI 0.00046-0.19641) and a strong statistically significant association between surgery and disease progression/recurrence (p = 0.001, CI 0.08713-0.03145). Women treated conservatively are significantly less fit hence suffering high cancer unrelated mortality; as a consequence they suffer higher disease related progression and mortality. In our study surgical treatment with adjuvant endocrine and/or radiotherapy was associated with a statistically significant advantage in terms of disease related mortality and local disease control.
Breast Unit, Sunderland Royal Hospital, Kayll Road, United Kingdom. matei.dordea@nhs.net
Matei
M
Dordea
Rhys
R
Jones
Andrea Pujol
AP
Nicolas
Sar
S
Sudeshna
John
J
Solomon
Peter
P
Truran
Anne
A
Fetherson
Obi
O
Iwuchukwu
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D012189:Retrospective Studies; D016896:Treatment Outcome