Surgery improves survival in elderly with breast cancer. A study of 465 patients in a single institution

Cortadellas, T.; Córdoba, Octavi; Gascón, A.; Haladjian, C.; Bernabeu, A. Ávila; Alcalde, Ana; Esgueva, Antonio; Rodríguez-Revuelto, R.; Espinosa-Bravo, Martín; Diaz-Botero, Sebastián; Xercavins, Jordi; Rubio, Isabel T.; Gil‐Moreno, Antonio

doi:10.1016/j.ejso.2015.01.027

Cited by 19 publications

(11 citation statements)

References 23 publications

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“…Based on data from the entire Danish population, our findings agree well with those of other studies [11][12][13][14][15] showing that breast cancer patients aged 70 years or more are diagnosed with more advanced disease (larger tumors, more often node positive) than younger patients. Our results also confirm that older patients receive different surgery with more biopsies only, more mastectomies than breast conserving surgery, and less axillary surgery.…”

Section: Discussionsupporting

confidence: 91%

Adherence to treatment guidelines and survival in older women with early-stage breast cancer in Denmark 2008–2012

et al. 2020

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Objectives: The aims of this study were to compare patients 70 years or older with younger patients, to examine whether Danish patients with early-stage breast cancer aged 70 years or more received treatment according to guidelines, the reasons for deviating from the guidelines, and to analyze whether such deviations affected survival. Methods: From the Danish Breast Cancer Cooperative Group (DBCG) database we identified 23,247 women diagnosed with early-stage breast cancer in Denmark from 2008 to 2012. 17,391 were aged less than 70 years and 5856 were 70þ years. We reviewed medical charts of 441 patients aged 70þ years from Funen (a region of Denmark) to ascertain whether treatment was given according to the guidelines of DBCG and if not, the reason for deviating. Overall survival was analyzed by Cox proportional hazards models. Results: Up to age 80 years most women (94%) had surgery according to guidelines, decreasing to 41% in women aged 85þ years, the main reason for omitting surgery being patients' requests. Patients with breast cancer over the age of 80 years did not have an excess mortality compared with the general population in Funen. Compared with women who had surgery according to guidelines, women who did not have surgery had a significantly higher risk of dying with a hazard ratio (HR) of 8.38 (95% Confidence Intervals (CI) 4.46-15.8) if they were less than 80 years and HR ¼ 2.56 (95% CI 1.63-4.01) if they were 80 years or more (p ¼ .003 for interaction). Conclusions: Adherence to treatment according to guidelines decreases with increasing age, mainly for patients aged 80þ years. Our results suggest that surgery is important for the survival of patients aged less than 80 years.

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Section: Discussionsupporting

confidence: 91%

Adherence to treatment guidelines and survival in older women with early-stage breast cancer in Denmark 2008–2012

et al. 2020

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“…21 In addition, studies have shown that the best prognosis for breast cancer was found when the surgical procedure was associated with other treatments such as radiotherapy, chemotherapy and hormone therapy, which may be associated with the fact that these therapies help in the reduction of metastases to distance. 22 The mortality rate in this study was higher in women aged 50-69 years, 65.22% (n = 15), of whom 87% (n = 54) of the causes of mortality were cancer-related and its complications.…”

Section: Objectives Methodsmentioning

confidence: 99%

Análise de sobrevida de mulheres com câncer de mama

Dias

Martins

Gradim

2018

Rev enferm UFPE on line.

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Objective: to evaluate the survival, in five years, of women with breast cancer. Method: quantitative, descriptive, exploratory, documental study, consisting of 62 charts of women attended in an Extension Project. Data were analyzed by Fisher's Exact Test, Kaplan Meier Curve and software R. Results: 61.29% (n = 38) had breast cancer aged 50-69 years; 35.49% (n = 22) were metastasized; 37.1% (n = 23) of them died, and the greatest cause was 87% breast cancer (n = 54). The survival rate was 80%, with an average time of 11.27 years. Women who had metastases had 3.67 more chances of dying (p = 0.00658), therefore, they had a shorter survival (p = 00171). Conclusion: the incidence of breast cancer was higher in patients aged 50-69 years, which is in agreement with the coverage of screening programs recommended by the Ministry of Health. Descriptors: Breast neoplasms; Survival analysis; Oncology Nursing. RESUMOObjetivo: avaliar a sobrevida, em cinco anos, de mulheres com câncer de mama. Método: estudo quantitativo, descritivo, exploratório, documental, constituído de 62 prontuários de mulheres atendidas em um Projeto de Extensão. Os dados foram analisados pelo Teste Exato de Fisher, Curva de Kaplan Meier e software R. Resultados: 61,29% (n=38) tiveram câncer de mama com idade entre 50-69 anos; 35,49% (n=22) foram acometidas por metástase; 37,1% (n=23) delas morreram, sendo que a maior causa foi o câncer de mama 87% (n=54). A sobrevida foi de 80%, com tempo médio de 11,27 anos. As mulheres que tiveram metástase possuíam 3,67 mais chances de morrer (p=0,00658), por isso, elas tiveram uma sobrevida menor (p= 00171). Conclusão: a incidência do câncer de mama foi maior em pacientes com faixa etária de 50-69 anos, o que está em acordo com a cobertura de programas de rastreamento preconizados pelo Ministério da Saúde. Descritores: Neoplasias da Mama; Análise de Sobrevida; Enfermagem Oncológica. RESUMENObjetivo: evaluar la supervivencia, en cinco años, de mujeres con cáncer de mama. Método: estudio cuantitativo, descriptivo, exploratorio, documental, constituido de 62 prontuarios de mujeres atendidas en un Proyecto de Extensión. Los datos fueron analizados por la Prueba Exacta de Fisher, Curva de Kaplan Meier y software R. Resultados: 61.29% (n = 38) tuvieron cáncer de mama con edad de 50-69 años; El 35.49% (n = 22) fueron acometidas por metástasis; 37.1% (n = 23) de ellas murieron, siendo que la mayor causa fue el cáncer de mama 87% (n = 54). La sobrevida fue del 80%, con tiempo promedio de 11.27 años. Las mujeres que tuvieron metástasis tenían 3.67 más veces de morir (p = 0.00658), por lo, que tuvieron una supervivencia menor (p = 00171). Conclusión: la incidencia del cáncer de mama fue mayor en pacientes con edades de 50-69 años, lo que está en acuerdo con la cobertura de programas de rastreo preconizados por el Ministerio de Salud. Descriptores:

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“…Mastectomy or breast conserving surgery remains the standard of care for women of any age, unless they are not surgical candidates, refuse surgery, or have a limited life expectancy (< 2-3 years). Surgery improves breast cancer-specific survival in octogenarians with early stage breast cancer [8,9], and has a low post-operative mortality rate, i.e., 0.5% [10]. In contrast, in elderly women (70 y plus) with locally advanced disease (Stage III) breast cancer-specific survival was the same in surgical and non-surgical groups [9].…”

Section: Surgerymentioning

confidence: 99%

“…Surgery improves breast cancer-specific survival in octogenarians with early stage breast cancer [8,9], and has a low post-operative mortality rate, i.e., 0.5% [10]. In contrast, in elderly women (70 y plus) with locally advanced disease (Stage III) breast cancer-specific survival was the same in surgical and non-surgical groups [9]. In frail elderly women with hormone receptor positive tumors who are unfit for surgery, or women who refuse surgery, primary endocrine therapy should be offered [11].…”

Section: Surgerymentioning

confidence: 99%

Breast cancer treatment in women over the age of 80: A tailored approach

Glaser

Marinopoulos²,

Dimitrakakis

2018

Maturitas

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Breast cancer treatment in women over the age of 80 remains a complex issue due to pre-existing comorbidities, therapy-related toxicities, and the lack of evidence-based data in this population, leading to both overtreatment and under treatment. The average life expectancy of an 80-year-old woman is 9.7 years and chronologic age alone should not be a factor in withholding therapy. Women over age 80 should be treated on an individual basis, taking into account their overall health and life expectancy, their risk of dying from breast cancer versus other causes, and the benefits versus toxicities of therapies for their tumor. Invaluable online tools are readily available to easily assess life expectancy (ePrognosis), as well as the absolute survival benefits for every tumor type and stage in individual patients (PREDICT, Ajuvant!). This information should be presented to the patient so that they are able to make an informed decision based on their goals, wishes and quality of life. Vulnerable patients should not be bullied or scared into taking unwanted or unnecessary treatments.

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Surgery improves survival in elderly with breast cancer. A study of 465 patients in a single institution

Cited by 19 publications

References 23 publications

Adherence to treatment guidelines and survival in older women with early-stage breast cancer in Denmark 2008–2012

Adherence to treatment guidelines and survival in older women with early-stage breast cancer in Denmark 2008–2012

Análise de sobrevida de mulheres com câncer de mama

Breast cancer treatment in women over the age of 80: A tailored approach

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