# A Single-Center 11-Year Experience of Surgical Management of Breast Cancer in Patients Aged 90 Years or Older

## TL;DR

This study shows that breast cancer surgery is safe and effective for women aged 90 or older with early-stage cancer, offering good outcomes and minimal complications.

## Contribution

The study provides evidence supporting the safety and efficacy of breast cancer surgery in nonagenarians.

## Key findings

- Surgery for breast cancer in women aged 90 or older had minimal post-operative complications.
- Mean disease-free survival was 96.7 months, and mean overall survival was 68.5 months.
- 26.4% of patients developed recurrence, and 70.5% died during the follow-up period.

## Abstract

Background

Surgery as a curative option for breast cancer is only offered to a fraction of women aged ≥90 years due to the lack of evidence supporting use of surgery in this patient group. This retrospective cohort study was undertaken to review patient outcomes following surgical treatment for breast cancer among women aged ≥ 90 years within our unit.

Methods

Retrospective case notes review and collection of clinicopathological data on 34 patients aged ≥ 90 years with early breast cancer who had surgery between 7th June 2007 and 31st July 2018 were carried out. Overall survival and disease-free survival were estimated using Kaplan-Meier survival analysis, with significance set to p <0.05.

Results

The median age of patients in the study was 90 years (range=90-101 years). The patients in this study were clinically fit and had Eastern Cooperative Oncology Group (ECOG) performance scores of 1 (67.6%) and 2 (32.4%). The mean tumour size was 33 mm (range=5-110mm).

A total of 28 patients (82.3%) underwent a mastectomy, two (5.8%) of which were bilateral. Six patients (17.6%) had a wide local excision, 13 axillary lymph node clearances were performed at the primary surgery, and none of the patients in the study developed any major post-operative complications.

A total of 25 patients (73.5%) had adjuvant endocrine therapy, and ten (29.4%) required adjuvant radiotherapy. None of the patients received adjuvant chemotherapy.

Over a median follow-up of 6.2 years, eight patients (26.4%) developed recurrence of disease, and 24 (70.5%) patients died at the time of data collection. Mean disease-free survival was 96.7 months (95% CI, 80.3- 113.2 months), and mean overall survival was estimated to be 68.5 months (95% CI, 35-84 months).

Conclusions

Breast cancer surgery is safe with minimal complications in medically fit women aged ≥ 90 years with early non-metastatic breast cancer and offers good local control.