Chia Zoe, Parks Ruth M, Cheung Kwok-Leung
School of Medicine, Nottingham Breast Cancer Research Centre, Royal Derby Hospital Centre, University of Nottingham, Uttoxeter Road, Derby, DE22 3DT, UK.
Oncol Ther. 2021 Dec;9(2):373-383. doi: 10.1007/s40487-021-00170-4. Epub 2021 Sep 16.
Surgery is the recommended treatment modality for primary breast cancer. Breast cancer surgery is non-visceral; therefore, it is often assumed that the subsequent impact on functional status in older women is less significant compared to other cancer types such as colorectal cancer. Evidence for this however, is lacking. The definition of functional status varies amongst healthcare professionals and patients, making comparisons between studies difficult. From the literature, the two most common themes in relation to functional status following breast cancer surgery are activities of daily living and quality of life. Both of these elements of functional status are adversely impacted in patients following breast cancer surgery. A more significant decline is seen in patients with pre-existing comorbidities and with greater intensity of surgery, which includes more invasive breast and/or axillary surgery as well as additional reconstructive procedures. Identifying and optimising pre-existing factors which may predict post-operative decline in functional status, such as cognitive impairment and deteriorating functional decline over the preceding year, may help in reducing deterioration in functional status after breast cancer surgery. Methods which may be employed to detect and optimise these factors include geriatric assessment and exercise intervention.
手术是原发性乳腺癌的推荐治疗方式。乳腺癌手术不涉及内脏；因此，人们通常认为，与结直肠癌等其他癌症类型相比，其对老年女性功能状态的后续影响较小。然而，目前缺乏相关证据。医疗保健专业人员和患者对功能状态的定义各不相同，这使得不同研究之间难以进行比较。从文献来看，乳腺癌手术后功能状态方面最常见的两个主题是日常生活活动和生活质量。乳腺癌手术后患者的这两个功能状态要素均受到不利影响。在已有合并症的患者以及手术强度更大（包括更具侵入性的乳房和/或腋窝手术以及额外的重建手术）的患者中，功能状态下降更为明显。识别并优化可能预测术后功能状态下降的既有因素，如认知障碍和前一年功能衰退加剧等，可能有助于减少乳腺癌手术后功能状态的恶化。可用于检测和优化这些因素的方法包括老年评估和运动干预。
