Outcomes After Mastectomy and Lumpectomy in Octogenarians and Nonagenarians with Early-Stage Breast Cancer

Prospective studies have shown equal outcomes after mastectomy or breast conservation in patients with invasive breast cancer; however, many of these studies excluded elderly patients. We identified patients in their eighties and nineties with clinical stage 0 to II breast cancer undergoing mastectomy or lumpectomy with or without radiation from the prospective sentinel lymph node (SLN) database at Wake Forest Baptist Health and analyzed their treatment and survival. Of 92 patients, 24 (26.1%) underwent mastectomy, 22 (23.9%) lumpectomy with radiation, and 46 (50.0%) lumpectomy alone. Significant differences were noted in tumor size (p=0.018), nodal status (p=0.013), and stage (p=0.011) across the groups. Only 7.6% of patients had chemotherapy, while 65.3% took anti-estrogen therapy. Recurrence occured in 11 (12.0%) patients. In univariate analysis, overall survival did not differ by surgery. Age was the only factor that increased risk of death (HR=1.19, p=0.028). Neither tumor factors nor type of local treatment significantly influenced overall survival. Octogenarians and nonagenarians with early-stage breast cancer undergoing breast-conserving surgery with or without radiation have equivalent survival to patients having a mastectomy.Master of Public Healt