Age affects decisions related to breast cancer surgery

A new BJS (British Journal of Surgery) study indicates that breast cancer surgery is safe for patients who are older than 70 years of age, but age can influence the decision to undergo surgery.

The Bridging the Age Gap in Breast Cancer study was conducted to determine factors influencing treatment decisions and outcomes from surgery for older breast cancer patients. Of 3,375 recruited women, surgery was performed in 2,816 patients. Serious adverse events were rare and there were no deaths attributed to surgery. Age, ill health, and frailty all impacted decisions related to surgery. Surgery had a negative impact on quality of life and functional independence.

"These data are very reassuring for women facing treatment choices including surgery, but we must remember that 18% of this cohort did not have surgery, just primary endocrine therapy," said co-first author Jenna Morgan, MD, of the University of Sheffield Medical School, in the UK. "Surgeons select out the least fit women for primary endocrine therapy and undoubtedly if we operated on 'all comers' we would see more adverse outcomes. The issue is to know where to set the selection threshold for optimal outcomes." The investigators' online Age Gap Decision Tool may help support this decision-making process.