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proLékaře.cz / Journals / Perspectives in Surgery / 2024 - 7

Breast cancer in 80+ year olds

Czech version

Authors: P. Kosáč 1;  M. Zábojníková 2;  P. Vážan 3;  V. Petrů 1;  M. Ratajský 1;  K. Lajmar 1;  B. Dudešek 1;  P. Kudlová 5;  J. Duben 1;  L. Podrazká 4;  J. Gatěk 1,5
Authors‘ workplace: Chirurgické oddělení, EUC Klinika Zlín 1;  Onkologické oddělení, Krajská nemocnice T. Bati, a. s., Zlín 2;  EUC laboratoře CGB a. s., pracoviště patologie Zlín 3;  Radiodiagnostika, EUC Klinika Zlín 4;  Ústav zdravotnických věd, Fakulta humanitních studií UTB ve Zlíně 5
Published in: Rozhl. Chir., 2024, roč. 103, č. 7, s. 258-262.
Category: Original articles
doi: https://doi.org/10.48095/ccrvch2024258

Overview

Introduction: The risk of breast cancer increases with increasing age. The aim of our retrospective study was to determine the extent of breast and axillary surgery, including subsequent adjuvant therapy, in 80-year and older patients.

Methods: Between 2017 and 2021, 834 breast cancer patients were operated in the Surgical Department of the EUC Clinic. Ninety-eight women (2× with bilateral cancer) and 2 men were included in this retrospective study. A total of 102 breast cancer cases in patients older than 80 years were analyzed. The surgical procedure corresponded to the stage of the disease and the general condition of the patient. Adjuvant systemic therapy was indicated according to the same principles.

Results: At the time of surgery, the patients were more than 80 years old (80–96 years). The predominant type of invasive ductal carcinoma was diagnosed 83×, lobular carcinoma 6×, mucinous 6×, papillary carcinoma 4×, other 3×, with luminal A, B predominating (89×). The breast-conserving procedures were performed 63×. Sentinel node biopsy was performed 65×, supplemented by axillary lymph node dissection 13×. Primary axillary lymph node dissection was performed 15×. No axillary procedure was performed 23×. Radiotherapy was given 49×, chemotherapy 9× and hormonal therapy 82×. Local and regional recurrences were each observed 2×. A total of 37 patients died, 10 of them from breast cancer.

Conclusion: The most common cause of death in patients aged 80+ years is a cardiovascular disease, not breast cancer itself. This fact should be taken into account when determining the treatment plan.

Keywords:

breast cancer – surgical therapy – 80 years

Sources
  1. Sharma R. ASO author reflections: eighty is the new sixty-breast cancer treatment strategies in the octogenarian patient population. Ann Surg Oncol 2018; 25(Suppl 3): 697–698. doi: 10.1245/ s10434-018-7071-8.
  2. Mamtani A, Gonzalez J, Dayna T et al. Treatment strategies in octogenarians with early-stage, high-risk breast cancer. Ann Surg Oncol 2018; 25(6): 1495–1501. doi: 10.1245/s10434-018-6350-8.
  3. Schonberg M, Rebecca A, Silliman M et al. Factors noted to affect breast cancer treatment decisions of women aged 80 and older. J Am Geriatr Soc 2012; 60(3): 538–544. doi: 10.1111/j.1532-5415.2011.03820.
  4. Glaser R, Marinopoulos S, Dimitrakakis C. Breast cancer treatment in women over the age of 80: a tailored approach. Maturitas 2018; 110: 29–32. doi: 10.1016/j. maturitas.2018.01.014.
  5. Mamtani A, Gonzalez J, Dayna Neo D et al. Early-stage breast cancer in the octogenarian: tumor characteristics, treatment choices, and clinical outcomes. Ann Surg Oncol 2016; 23(10): 3371–3378. doi: 10.1245/s10434-016-5368-z.
  6. Freedman RA. Treatment of breast cancer in the elderly. Curr Oncol Rep 2015; 17(11): 517–516. doi: 10.1007/s11912-015-0475-8.
  7. Al-Rashdan A, Xu A, Quan M et al. Higher-risk breast cancer in women aged 80 and older: exploring the effect of treatment on survival. Breast 2021; 59: 203–210. doi: 10.1016/j.breast.2021.07.005.
  8. Cortadellas T, Gascón A, Córdoba O et al. Surgery improves breast cancer-specific survival in octogenarians with early-stage breast cancer. Int J Surg 2013; 11(7): 554–557. doi: 10.1016/j.ijsu.2013.05.032.
  9. Tesarova P. Breast cancer in the elderly – should it be treated differently? Rep Pract Oncol Radiother 2013; 18(1): 26–33. doi: 10.1016/j.rpor.2012.05.005.
  10. Boughey J, Haffty B, Habermann E et al. Has the time come to stop surgical staging of the axilla for all women age 70 years or older with hormone receptor-positive breast cancer? Ann Surg Oncol 2017; 24(3): 614–617. doi: 10.1245/s10434-016-5740-z.
  11. Shachar S, Hurria A, Muss H. Breast cancer in women older than 80 years. J Oncol Pract 2016; 12(2): 123–132. doi: 10.1200/ JOP.2015.010207.
  12. Liang S, Hallet J, Simpson J et al. Omission of axillary staging in elderly patients with early stage breast cancer impacts regional control but not survival: a systematic review and meta-analysis. J Geriatr Oncol 2017; 8(2): 140–147. doi: 10.1016/j. jgo.2016.12.003.
  13. Hughes K, Schnaper L, Berry D et al. Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer. N Engl J Med 2004; 351(10): 971–977. doi: 10.1056/NEJMoa040587.
  14. Strader L, Helmer SD, Yates CL et al. Octogenarians: noncompliance with breast cancer treatment recommendations. Am Surg 2014; 80(11): 1119–1123. doi: 10.1177/000313481408001127.
  15. Martelli G, Boracchi P, Guzzetti E et al. Omission of radiotherapy in elderly patients with early breast cancer: 15-year results of a prospective non-randomised trial. Eur J Cancer 2015; 51(11): 1358–1364. doi: 10.1016/j.ejca.2015.04.018.
  16. Eaton BR, Jiang R, Torres MA et al. Benefit of adjuvant radiotherapy after breastconserving therapy among elderly women with T1-T2N0 estrogen receptor-negative breast cancer. Cancer 2016; 122(19): 3059–3068. doi: 10.1002/cncr.30142.
  17. Valassiadou K, Morgan DA, Robertson JF et al. Successful management of elderly breast cancer patients treated without radiotherapy. World J Surg Oncol 2007; 5: 62. doi: 10.1186/1477–7819-5-62.
  18. Schonberg M, Marcantonio E, Li D et al. Breast cancer among the oldest old: tumor characteristics, treatment choices, and survival. J Clin Oncol 2010; 28(12): 2038–2045. doi: 10.1200/ JCO.2009.25.9796.
  19. Chatzidaki P, Mellos M, Briese V et al. Does primary breast cancer in older women (≥80 years) have unfavorable histological characteristics? Arch Gynecol Obstet 2011; 284(3): 705–712. doi: 10.1007/s00404-010-1697-5.
  20. Yamada A, Narui K, Sugae S et al. Operation with less adjuvant therapy for elderly breast cancer. J Surg Res 2016; 204(2): 410–417. doi: 10.1016/j. jss.2016.05.031.

doc. MUDr. Jiří Gatěk, Ph.D.
Chirurgické oddělení EUC Klinika Zlín
třída Tomáše Bati 5135, 760 01 Zlín
gatekj@gmail.com

ORCID autora
J. Gatěk 0000-0002-5824-9613

Labels
Surgery Orthopaedics Trauma surgery
Tradiční Rozhledy v novém
Budoucnost mamologie
Current trends in breast cancer surgery
Surgical treatment of breast cancer associated with pregnancy and lactation
Breast cancer localization by iodine seed 125I vs. wire- -guided localization – retrospective case-control study
Surgical treatment of breast precancers – our experience
The variable histogenesis and biology of selected bland fibroblastic lesions of the breast – pitfalls in the differential diagnostics and optimal therapeutic approach (three case reports)
Article was published in

Perspectives in Surgery

Issue 7
2024 Issue 7
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