Thirty-day postoperative morbidity and mortality in elderly women with breast cancer: an analysis of the NSQIP database

• Published in: Breast cancer research and treatment 2018-07, Vol.170 (2), p.373-379
• Main Authors: Angarita, Fernando A., Acuna, Sergio A., Cordeiro, Erin, Elnahas, Ahmad, Sutradhar, Subir, Jackson, Timothy, Cil, Tulin D.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Analysis; Breast cancer; Breast Neoplasms - epidemiology; Breast Neoplasms - mortality; Breast Neoplasms - surgery; Breast reconstruction; Cancer research; Cancer surgery; Chemotherapy; Comorbidity; Databases, Factual; Elderly patients; Epidemiology; Female; Geriatrics; Heart diseases; Humans; Invasiveness; Lumpectomy; Lymph nodes; Mastectomy; Medicine; Medicine & Public Health; Middle Aged; Morbidity; Mortality; Myocardial infarction; Older people; Oncology; Patient outcomes; Postoperative Complications; Postoperative Period; Quality control; Retrospective Studies; Surgery; Surgical site infections; Thromboembolism; Women; Wounds
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-018-4747-5

Purpose Postoperative complication rates for elderly women undergoing breast cancer surgery have not been well studied. We describe the postoperative complication rates of elderly (≥ 70 years) women with breast cancer and compare them with young (40–69 years) women. Methods Data were extracted from the National Surgical Quality Improvement Program database (2004–2014). We included women with invasive breast cancer who underwent surgery. Outcomes were 30-day postoperative morbidity and mortality (complications), which were compared between young and elderly women. Morbidity was categorized using the Surgical Risk Preoperative Assessment System (SURPAS) clusters. Results We identified 100,037 women of which 26.7% were elderly. Compared to young women, elderly women were more likely to have more comorbidities and undergo breast-conserving surgery, but less likely to undergo lymph node surgery, breast reconstruction, and neoadjuvant chemotherapy. While the 30-day overall morbidity rate was not significantly different between young and elderly women (3.9 vs. 3.8%, p  = 0.2), elderly women did have significantly higher rates of pulmonary, cardiac (arrest and myocardial infarction), venous thromboembolic, and neurological morbidity. Specific morbidities that showed significantly lower rates among elderly women included wound disruption and deep and organ space surgical site infection. Any cause death was significantly higher in elderly compared to young women (0.2 vs. 0.05%, p