Retrospective study of locoregional recurrence and mortality after breast cancer surgery in patients aged 85 years and older

Since life expectancy is increasing the number of patients aged 85 years and older with breast cancer (BC) may be on the rise. A retrospective study using Oncoshare (a database that links Stanford Healthcare and Sutter Health electronic medical records with the California Cancer Registry) evaluated surgical management and outcomes in this cohort. From 2010 to 2019, 91 surgically treated patients (71% aged 85-89 and 29% aged ≥ 90 years) with primary or in-breast tumor recurrence (IBTR) were identified. Lumpectomy was performed in 70% of 96 cancers, and nodal staging in 36% of lumpectomies and 91% of mastectomies. Locoregional recurrene occurred in 18 patients. The BC-specific survival rate was 100% at 3 years and 98% (95% CI 94.3-100) at 5 years; overall survival (OS) rate was 77.9% (68.8-88.1) at 3 years and 59.9% (49.3-72.6) at 5 years, with 5-year OS rate 71.9% (60.4-85.6) for patients aged 85-89 years and 28.3% (13.6-58.6) for those aged ≥ 90 years. Median OS was 7.6 among patients aged 85-89 years and 3.5 years among patients aged ≥ 90 years. The cumulative incidence was 4.6% (95% CI 2.2-9.0) at 3 years and 13.4% (5.9-20.8) at 5 years, factoring death as a competing risk using the Aalen-Johansen estimator. The authors conclude that surgery achieves satisfactory local control of disease in patients aged ≥ 85 years with a new BC or IBTR.