Monib Sherif, Elkorety Mohamed, Habashy Hany
St Albans Hospital Breast Unit, West Hertfordshire Hospitals NHS Trust, Waverley Rd, St Albans, AL3 5PN UK.
General Surgery Department, Fayoum University Hospital, Faiyum, Egypt.
Indian J Surg Oncol. 2021 Dec;12(4):785-791. doi: 10.1007/s13193-021-01442-1. Epub 2021 Sep 6.
Breast cancer (BC) risk increases with age; about a third of patients are diagnosed in age older than 65. Treatment of this age group remains controversial, leading to inferior outcomes with lower survival rates than younger patients. We aimed to evaluate performance status tools as well as the outcome of management of breast cancer in the geriatric population. We have conducted a retrospective database analysis looking into the management of breast cancer patients older than 65 years old presenting to our unit during the period between June 2015 and June 2019. All patients had triple assessment as well as multimodality performance status assessment with their treatment modalities, and outcomes are recorded and assessed. We have included 578 patients, 0.8% male and 99.2% female, and our patients' mean age was 71 years. Most of our patients scored one or two on the WHO/ECOG performance status score and Clinical Frailty Score, as well as ASA-PS score. 3.2% had no treatment, 4.3% had endocrine therapy only, 0.5% had primary endocrine therapy followed by surgery, and 92.3% underwent surgery with 4.1% complication rate. Patients who underwent breast-conserving surgery had adjuvant breast radiotherapy, and 23.7% had adjuvant chest wall radiotherapy, 78.8% had adjuvant endocrine treatment, and 4.8% had adjuvant chemotherapy out of which 30.7% had adjuvant chemotherapy and Herceptin. Objective assessment tools should be used for patients older than 65 years diagnosed with primary breast cancer to be able to scarify patients' individualised treatment options to reach the optimum outcome.
乳腺癌（BC）风险随年龄增长而增加；约三分之一的患者在65岁以上被诊断出。该年龄组的治疗仍存在争议，导致其预后比年轻患者差，生存率较低。我们旨在评估老年人群中乳腺癌的功能状态评估工具以及治疗结果。我们进行了一项回顾性数据库分析，研究2015年6月至2019年6月期间在我院就诊的65岁以上乳腺癌患者的治疗情况。所有患者均接受了三重评估以及与其治疗方式相关的多模式功能状态评估，并记录和评估了结果。我们纳入了578例患者，其中男性占0.8%，女性占99.2%，患者的平均年龄为71岁。我们的大多数患者在世界卫生组织/东部肿瘤协作组（WHO/ECOG）功能状态评分、临床衰弱评分以及美国麻醉医师协会身体状况评分（ASA-PS）中得分为1分或2分。3.2%的患者未接受治疗，4.3%的患者仅接受内分泌治疗，0.5%的患者先接受内分泌治疗然后进行手术，92.3%的患者接受了手术，并发症发生率为4.1%。接受保乳手术的患者接受了辅助性乳腺放疗，23.7%的患者接受了辅助性胸壁放疗，78.8%的患者接受了辅助性内分泌治疗，4.8%的患者接受了辅助性化疗，其中30.7%的患者接受了辅助性化疗和赫赛汀治疗。对于65岁以上诊断为原发性乳腺癌的患者，应使用客观评估工具，以便能够牺牲患者的个体化治疗方案来达到最佳治疗效果。
