Fernando A Angarita1, Sergio A Acuna1, Erin Cordeiro2, Ahmad Elnahas1,3, Subir Sutradhar1, Timothy Jackson1,3, Tulin D Cil4,5,6. 1. Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada. 2. Division of General Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada. 3. Division of General Surgery, University Health Network, 700 University Ave, OPG- 6th Floor, Toronto, ON, M5G 2M9, Canada. 4. Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada. Tulin.Cil@uhn.ca. 5. Division of General Surgery, University Health Network, 700 University Ave, OPG- 6th Floor, Toronto, ON, M5G 2M9, Canada. Tulin.Cil@uhn.ca. 6. Division of General Surgery, Women's College Hospital, Toronto, ON, Canada. Tulin.Cil@uhn.ca.
Abstract
PURPOSE: Postoperative complication rates for elderly women undergoing breast cancer surgery have not been well studied. We describe the postoperative complication rates of elderly (≥ 70 years) women with breast cancer and compare them with young (40-69 years) women. METHODS: Data were extracted from the National Surgical Quality Improvement Program database (2004-2014). We included women with invasive breast cancer who underwent surgery. Outcomes were 30-day postoperative morbidity and mortality (complications), which were compared between young and elderly women. Morbidity was categorized using the Surgical Risk Preoperative Assessment System (SURPAS) clusters. RESULTS: We identified 100,037 women of which 26.7% were elderly. Compared to young women, elderly women were more likely to have more comorbidities and undergo breast-conserving surgery, but less likely to undergo lymph node surgery, breast reconstruction, and neoadjuvant chemotherapy. While the 30-day overall morbidity rate was not significantly different between young and elderly women (3.9 vs. 3.8%, p = 0.2), elderly women did have significantly higher rates of pulmonary, cardiac (arrest and myocardial infarction), venous thromboembolic, and neurological morbidity. Specific morbidities that showed significantly lower rates among elderly women included wound disruption and deep and organ space surgical site infection. Any cause death was significantly higher in elderly compared to young women (0.2 vs. 0.05%, p < 0.001). CONCLUSIONS: While some specific 30-day postoperative morbidities were more often seen in elderly women, the overall 30-day postoperative complication rate was very low. These data support the safety of breast cancer surgery in well-selected elderly patients.
PURPOSE: Postoperative complication rates for elderly women undergoing breast cancer surgery have not been well studied. We describe the postoperative complication rates of elderly (≥ 70 years) women with breast cancer and compare them with young (40-69 years) women. METHODS: Data were extracted from the National Surgical Quality Improvement Program database (2004-2014). We included women with invasive breast cancer who underwent surgery. Outcomes were 30-day postoperative morbidity and mortality (complications), which were compared between young and elderly women. Morbidity was categorized using the Surgical Risk Preoperative Assessment System (SURPAS) clusters. RESULTS: We identified 100,037 women of which 26.7% were elderly. Compared to young women, elderly women were more likely to have more comorbidities and undergo breast-conserving surgery, but less likely to undergo lymph node surgery, breast reconstruction, and neoadjuvant chemotherapy. While the 30-day overall morbidity rate was not significantly different between young and elderly women (3.9 vs. 3.8%, p = 0.2), elderly women did have significantly higher rates of pulmonary, cardiac (arrest and myocardial infarction), venous thromboembolic, and neurological morbidity. Specific morbidities that showed significantly lower rates among elderly women included wound disruption and deep and organ space surgical site infection. Any cause death was significantly higher in elderly compared to young women (0.2 vs. 0.05%, p < 0.001). CONCLUSIONS: While some specific 30-day postoperative morbidities were more often seen in elderly women, the overall 30-day postoperative complication rate was very low. These data support the safety of breast cancer surgery in well-selected elderly patients.
Entities:
Keywords:
Aged; Breast neoplasms; Morbidity; Mortality; Surgery
Authors: Krissia M Rivera Perla; Nathan J Pertsch; Owen P Leary; Catherine M Garcia; Oliver Y Tang; Steven A Toms; Robert J Weil Journal: Surg Neurol Int Date: 2021-04-08
Authors: Jacquelyn Dillon; Samantha M Thomas; Laura H Rosenberger; Gayle DiLalla; Oluwadamilola M Fayanju; Carolyn S Menendez; E Shelley Hwang; Jennifer K Plichta Journal: Ann Surg Oncol Date: 2021-07-26 Impact factor: 4.339