Postoperative Complications After Breast Cancer Surgery are Not Related to Age

• Published in: Annals of surgical oncology Vol. 24; no. 7; pp. 1861 - 1867
• Main Authors: ten Wolde, Britt, Kuiper, Michelle, de Wilt, Johannes H. W., Strobbe, Luc J. A.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-07-2017; Springer Nature B.V
• Subjects: Adolescent; Adult; Age; Age Factors; Aged; Axilla; Biopsy; Body mass; Body mass index; Breast cancer; Breast Neoplasms - surgery; Breast Oncology; Cancer surgery; Classification; Clinical trials; Fear; Female; Follow-Up Studies; Geriatrics; Humans; Lumpectomy; Lymph; Lymph nodes; Mastectomy; Mastectomy - adverse effects; Medicine; Medicine & Public Health; Middle Aged; Oncology; Patients; Population studies; Postoperative Complications - etiology; Postoperative period; Prognosis; Prospective Studies; Risk Factors; Surgery; Surgical Oncology; Young Adult; Complication Risk; Bilateral Breast Cancer; Lymphedema; Young Breast Cancer Patient; Breast Cancer
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-016-5726-x

Introduction
Consensus about surgical treatment options for breast cancer in elderly patients remains elusive due to exclusion from clinical trials. Fear of complications due to increased age often is an important factor in the choice of treatment and might result in different treatment of the older patient.
Methods
A total of 1258 female patients who underwent breast cancer surgery for primary diagnosed breast cancer in 2010–2014 were included. Incidence of postoperative complications (POCs) was compared between the younger (18–70 years,
N
 = 1008) and older (≥71 years,
N
 = 250) patients. Multivariate logistic regression was performed to identify the correlation between age and POCs.
Results
POCs developed in 25.9% of the younger and 31.6% of the older patients (
p
 = 0.042). In multivariable logistic regression analysis of the overall study population, age was no risk factor for POC (odds ratio 0.950, 95% confidence interval 0.640–1.410,
p
 = 0.798). More extensive surgery (mastectomy and/or axillary lymph node dissection compared with single lumpectomy) and increased body mass index increased the odds of developing a POC. Analyses of the ≥71-year group separately revealed only type of surgery to be of influence.
Conclusions
Fear of increased risk of complications in the older patient is unjustified. Neither increased age nor high American Society of Anesthesiologists classification are predictors for developing POC. Type of surgery is the most important determinant. Choosing mastectomy while breast-conserving surgery is suitable should be discouraged, particularly in the older patient.