Surgical choices and complications in elderly women: a single center retrospective analysis in frail vs. non frail breast cancer patients

IF 0.6 Q4 SURGERY

European Journal of Plastic Surgery Pub Date : 2023-09-16 DOI:10.1007/s00238-023-02122-9

Patrícia Machado e Costa, Márcio Debiasi, Bruna da Silva Reus, André Cardoso, David Pinto, Pedro Gouveia, Rogelio Andres-Luna, Carlos Mavioso, João Anacleto, Fátima Cardoso, Maria João Cardoso

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引用次数: 0

Abstract

Abstract Background Early breast cancer (EBC) in the elderly is a major public health problem and a risk factor for undertreatment. The authors aim to describe surgical patterns and outcomes of an elderly population diagnosed with EBC treated in a BC-dedicated reference center. Methods Retrospective study for all EBC patients ≥70 years old submitted to breast surgery from 2018 to 2021. Patients were included if submitted to the G8 screening tool. Data on standard demographics, surgery performed, and outcomes were collected. Results Overall, 192 patients were included. Frail patients were significantly older ( p <0.01), had worse Charlson Comorbidity Index ( p <0.01) and ASA ( p <0.01) scores and more comorbidities ( p =0.09). In total, 199 breasts were operated; 173 breast conservative surgeries (BCS) and 26 mastectomies. In the frail population, oncoplastic surgery after BCS was more frequently mammoplasty; no reconstruction was reported after mastectomy. In the fit group, more diversity was seen in oncoplastic procedures; 13 breasts underwent direct-to-implant breast reconstruction (BR) after mastectomy. Frail patients were less likely to be offered BR ( p <0.01). There was no association between frailty and postoperative complications, in-hospital length of stay, readmission, or reintervention. Conclusions Our results suggest that G8 frail patients are less likely to be offered BR. Even if there were no significant differences in surgical adverse outcomes between groups, this could have been masked by a higher proportion of BR among fit patients. G8 screening can be a useful instrument to support the surgeon’s decision to whether or not to consider BR in elderly breast cancer patients. Level of Evidence: Level IV, Risk/Prognostic Study.

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老年妇女的手术选择和并发症:虚弱与非虚弱乳腺癌患者的单中心回顾性分析

背景:老年早期乳腺癌(EBC)是一个重大的公共卫生问题，也是治疗不足的危险因素。作者旨在描述在bc专用参考中心治疗的诊断为EBC的老年人群的手术模式和结果。方法回顾性研究2018 - 2021年所有≥70岁接受乳房手术的EBC患者。提交G8筛查工具的患者被纳入。收集了标准人口统计、手术和结果的数据。结果共纳入192例患者。体弱多病患者明显老年化(p <0.01)， Charlson合并症指数(p <0.01)和ASA评分较差(p <0.01)，合并症较多(p =0.09)。总共手术199个乳房;173例乳房保守手术(BCS)和26例乳房切除术。在身体虚弱的人群中，BCS后的肿瘤整形手术更常见的是乳房成形术;乳房切除术后无重建报告。在fit组中，肿瘤整形手术的多样性更大;13例乳房切除术后行直接植入乳房重建(BR)。体弱患者较少接受BR治疗(p <0.01)。虚弱与术后并发症、住院时间、再入院或再干预之间没有关联。结论我们的研究结果表明G8体弱患者不太可能提供BR。即使两组之间的手术不良结果没有显著差异，这也可能被健康患者中较高比例的BR所掩盖。在老年乳腺癌患者中，G8筛查可作为外科医生决定是否考虑BR的有用工具。证据等级:IV级，风险/预后研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Plastic Surgery SURGERY-

CiteScore

1.10

自引率

0.00%

发文量

期刊介绍： Europe has always been an area of dynamic development in plastic surgery. Its great strength has been the lack of uniformity of this development due to differing cultures, different traditions, and differing medical and surgical philosophies. Over the recent years, these changes have been even more striking and rapid. The European Journal of Plastic Surgery creates a focal point for the input of new advances in clinical techniques and in research. It thus becomes an educational vehicle. In addition to this, the journal provides information on what is going on elsewhere in the world, and it is also willing to accept contributions from outside of Europe. Fields of interest include general plastic and reconstructive surgery, head and neck surgery, aesthetic and craniofacial surgery, hand surgery, microsurgery, treatment of bones, trauma, burn management and basic research related to all aspects of plastic surgery.Submitted articles are first evaluated by the Editor in Chief and if judged appropriate, are peer-reviewed by at least two selected experts. Reviewers may be plastic surgeons or other surgical/ medical specialists with expertise in specific areas of research. Manuscripts provisionally accepted for publication may be returned to the author for corrections or clarifications, in response to suggestions by the Editorial Board or external reviewers, prior to final acceptance. Online submission and peer review for rapid online publication are offered through the Editorial Manager System. The system creates a PDF version of the submitted article for peer review, revision and proofing. All correspondence, including the request for revisions and final decision, is managed by e-mail. Authors are guided step by step through the full process and are kept up to date on the article’s progress at every stage. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.Reports of animal experiments must state that the ''Principles of laboratory animal care'' (NIH publication No. 86-23, revised in 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable.Acknowledgments of people, grants, funds, etc. should be placed in a separate section before the reference list. The names of funding organizations should be written in full. Authors are also required to disclose any relationships with public or private commercial or noncommercial entities, any institutional affiliations, or any personal associations that might pose a conflict of interest.The Editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfill the above-mentioned requirements.