J C Sierink1, S M M de Castro2, N S Russell3, M M Geenen4, E Ph Steller5, B C Vrouenraets6. 1. Department of Surgery, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands. Electronic address: j.c.sierink@amc.nl. 2. Department of Surgery, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands. Electronic address: stevedecastro@me.com. 3. Department of Radiotherapy, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121-123, 1066 CX, Amsterdam, The Netherlands. Electronic address: n.russell@nki.nl. 4. Department of Internal Medicine, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands. Electronic address: m.geenen@slaz.nl. 5. Department of Surgery, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands. Electronic address: e.steller@slaz.nl. 6. Department of Surgery, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands. Electronic address: bc.vrouenraets@slaz.nl.
Abstract
BACKGROUND: The aim of this study was to determine the role of surgery in elderly patients with breast cancer. METHODS: Between 1999 and 2009, 153 consecutive women, ≥80 years old with breast cancer were treated at our hospital. Surgically and non-surgically treated patients were compared with respect to characteristics and survival. RESULTS: Treatment was surgical in 102 patients (67%). The non-surgically treated patients were older than surgically treated patients, had more co-morbidity and were more often diagnosed with a clinically T3/T4 tumour and distant metastasis. Patients not receiving surgery, had an 11% overall survival rate at 5-year versus 48% in surgically treated patients (P < 0.001). Independent factors for survival were clinical N0 status, M0 status at presentation and surgery. CONCLUSION: One in three patients of 80 years and older did not have surgical treatment for breast cancer. Patient not treated surgically are older, have more severe co-morbidity and are diagnosed with more advanced disease than patients who underwent surgery.The selection of patients, who have a poor prognosis, is made on clinical grounds not measurable with a common co-morbidity survey. Better and evidence-based selection criteria for surgical and non-surgical treatment in these patients are needed.
BACKGROUND: The aim of this study was to determine the role of surgery in elderly patients with breast cancer. METHODS: Between 1999 and 2009, 153 consecutive women, ≥80 years old with breast cancer were treated at our hospital. Surgically and non-surgically treated patients were compared with respect to characteristics and survival. RESULTS: Treatment was surgical in 102 patients (67%). The non-surgically treated patients were older than surgically treated patients, had more co-morbidity and were more often diagnosed with a clinically T3/T4 tumour and distant metastasis. Patients not receiving surgery, had an 11% overall survival rate at 5-year versus 48% in surgically treated patients (P < 0.001). Independent factors for survival were clinical N0 status, M0 status at presentation and surgery. CONCLUSION: One in three patients of 80 years and older did not have surgical treatment for breast cancer. Patient not treated surgically are older, have more severe co-morbidity and are diagnosed with more advanced disease than patients who underwent surgery.The selection of patients, who have a poor prognosis, is made on clinical grounds not measurable with a common co-morbidity survey. Better and evidence-based selection criteria for surgical and non-surgical treatment in these patients are needed.
Authors: Marcelo Adeodato Bello; Raquel Ferreira de Menezes; Brunna Silva; Rafael de Carvalho da Silva; Rousiane Silva Cavalcanti; Thayane de Fátima da Costa Moraes; Fabiana Tonellotto; Suzana Sales de Aguiar; Renata Brum Martucci; Anke Bergmann; Luiz Claudio Thuler Journal: Asian Pac J Cancer Prev Date: 2016-10-01