Articles Open access

Invasive breast tumors in elderly women over ninety: a case series from a breast surgery center

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Published
8 January 2025
Section
Articles

Abstract

Surgical therapy for malignant breast neoplasms in women over the age of 90 is used with caution due to the possibility of immediate postoperative complications from extended hospital stays. These patients frequently exhibit frailty, multiple comorbidities, and a limited life expectancy. A retrospective analysis of patients aged 89 and older treated in 2023 at our certified breast surgery center was carried out. The goal was to examine the clinical characteristics, decision-making process, surgical treatment, outcomes, and open questions surrounding this high-risk subpopulation. Ten patients participated in the study. The characteristics of tumors treated with extended lumpectomy or mastectomy were investigated. The average hospital stay was 1.7 nights, and only one patient developed postoperative delirium. The median survival time is currently 8 months. Only one patient received any adjuvant therapy. A multidisciplinary approach in very elderly patients allows for the assessment of acceptable operative risks as well as the limitation of immediate, short-term, and medium-term complications, reducing reluctance to undergo surgical treatment.

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References

  1. Di Lascio S, Tognazzo E, Bigiotti S, et al. Breast cancer in the oldest old (≥ 89 years): Tumor characteristics, treatment choices, clinical outcomes and literature review. Eur J Surg Oncol 2021;47:796-803. DOI: https://doi.org/10.1016/j.ejso.2020.10.008
  2. Abdel-Razeq H, Abu Rous F, Abuhijla F, et al. Breast cancer in geriatric patients: current landscape and future prospects. Clin Interv Aging 2022;17:144560. DOI: https://doi.org/10.2147/CIA.S365497
  3. Wu B, Sun C, Sun X, Li X. The effect of chemotherapy on survival in oldest old patients with nonmetastatic triple negative breast cancer: A population based observational study. J Clin Pharm Ther 2022;47:1826-36. DOI: https://doi.org/10.1111/jcpt.13776
  4. Guo Q, Lan T, Lu Y, et al. Effectiveness of adjuvant chemotherapy for elderly patients with triple-negative breast cancer. Biomol Biomed 2023;23:502-9. DOI: https://doi.org/10.17305/bjbms.2022.8163
  5. Ring A, Battisti NML, Reed MWR, et al. Bridging The Age Gap: observational cohort study of effects of chemotherapy and trastuzumab on recurrence, survival and quality of life in older women with early breast cancer. Br J Cancer 2021;125:209-219. DOI: https://doi.org/10.1038/s41416-021-01388-9
  6. Wyld L, Reed MWR, Collins K, et al. Improving outcomes for women aged 70 years or above with early breast cancer: research programme including a cluster RCT. Programme Grants Appl Res 2022;10. DOI: https://doi.org/10.3310/XZOE2552
  7. Fusco D, Allocca E, Villani ER et al. An update in breast cancer management for elderly patients. Transl Cancer Res 2018;7:S319-28. DOI: https://doi.org/10.21037/tcr.2018.03.21
  8. Ferrigni E, Bergom C, Yin Z, et al. Breast cancer in women aged 80 years or older: an analysis of treatment patterns and disease outcomes. Clin Breast Cancer 2019;19:157-64. DOI: https://doi.org/10.1016/j.clbc.2019.01.007
  9. Overcash J, Ford N, Kress E, et al. Comprehensive geriatric assessment as a versatile tool to enhance the care of the older person diagnosed with cancer. Geriatrics (Basel) 2019;4:39. DOI: https://doi.org/10.3390/geriatrics4020039
  10. Biganzoli L, Battisti NML, Wildiers H, et al. Updated recommendations regarding the management of older patients with breast cancer: a joint paper from the European Society of Breast Cancer Specialists (EUSOMA) and the International Society of Geriatric Oncology (SIOG). Lancet Oncol 2021;22:e327-e340. DOI: https://doi.org/10.1016/S1470-2045(20)30741-5
  11. Reid-Agboola C, Klukowska A, Malcolm FL et al. Comprehensive geriatric assessment for older women with early-stage (non-metastatic) breast cancer-an updated systematic review of the literature. Curr Oncol 2023;30:8294-309. DOI: https://doi.org/10.3390/curroncol30090602
  12. Shivilov E, Anichkina K, Arslanov K, et al. Impact of comorbidity on surgical management of breast cancer in elderly patients. JCO 2024;42:e12596-e12596. DOI: https://doi.org/10.1200/JCO.2024.42.16_suppl.e12596
  13. Linea Guida: Valutazione multidimensionale della persona anziana. Sistema nazionale Linee Guida SNLG. Istituto Superiore di Sanità, 16.11.2023. Available from: https:/ww.iss.it/snlg-consultazione

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