AB140. Surgical management of breast cancer in the elderly

Background: Breast cancer is diagnosed after the age of 65 in 44% of cases. There is controversy regarding the optimal management of breast cancer diagnosed after the age of 70. Our aim was to examine outcomes of a modern cohort of Irish women diagnosed with breast cancer aged ≥70 who underwent therapeutic surgery.

Methods: We performed a retrospective review of a prospectively maintained database of all new breast cancers from January 2009 to December 2014 at The Mater Misericordiae University Hospital. We included all patients aged ≥70 at diagnosis who underwent resection of their primary tumour. Patient and tumour characteristics, treatment and outcomes were analysed.

Results: Five hundred and thirty-nine primary breast cancers were diagnosed in 488 patients. Two hundred and ninety-seven had surgical resection of their primary tumour. The mean age was 75.89 years. The mean tumour size was 2.52 cm. One hundred and thirty (43.8%) underwent mastectomy and 160 (53.9%) had breast conserving surgery. 185 (62.3%) had a sentinel lymph node biopsy and 78 (26.3%) had an axillary lymph node dissection. The majority of patients received hormonal and radiation therapy (223 and 197 respectively). During follow-up 98 (32.9%) died, of these, the mean time from surgery to death was 51 months. Ninety day mortality was 0.67%, with no 30-day mortalities recorded.

Conclusions: Breast cancer diagnosed at an older age is often treated less aggressively. This study shows that breast surgery carries a low risk of peri-operative mortality, even in elderly patients, suggesting that with careful patient selection, therapeutic surgery can be a safe and effective option.

Keywords: Breast cancer; elderly; surgery; hormone therapy