Clinical analysis of the elderly breast-cancer patients receiving individualized surgical treatment / 中华老年医学杂志

ABSTRACT

Objective:To explore the individualized surgical methods for elderly breast cancer patients.Methods:Elderly patients(aged≥70 years)with stage 0-Ⅲ breast cancer admitted to Beijing Tongren Hospital Affiliated to Capital Medical University from January 2013 to June 2020 were retrospectively analyzed.They were divided into three groups based on surgical methods: breast-conserving surgery, nipple-areola complex-sparing mastectomy and traditional mastectomy.Age, tumor size, lymph node involvement, hormone receptor status, anesthesia mode, surgical operation mode and patient prognosis were retrospectively analyzed.Results:A total of 144 patients(147 cases)were followed up for 8-96(36.5±10.7)months, with a median of 27 months.The overall survival rate was 88.9%, with breast cancer-related deaths at 6.3%, non-breast cancer-related deaths at 4.9%, local recurrence at 3.5%, and systemic metastasis at 5.6%.Among the three groups, 38.5%, 82.0% and 73.3%, respectively, received general anesthesia.Breast-conserving surgery showed the shortest operation time[(71.7±31.6)min vs.(84.8±24.8)min vs.(100.0±34.4)min, F=7.264, P=0.001], the lowest postoperative drainage volume[(39.5±75.4)ml vs.(154.92±135.6)ml vs.(334.1±287.2)ml, F=31.481, P<0.001]and the shortest drainage duration[(2.8±3.3)d vs.(6.3±2.8)d vs.(8.5±3.7)d, F=38.101, P<0.001]. Conclusions:The surgical treatment of elderly patients with breast cancer should be based on comprehensive evaluation and accurate molecular typing.Breast-conserving surgery is the preferred surgical method for elderly patients with hormone receptor-positive and cN0 breast cancer.Mastectomy with skin and nipple areola preservation where appropriate can improve the therapeutic effect and quality of life for elderly breast cancer patients.