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Thirty-day postoperative morbidity and mortality in elderly women with breast cancer: an analysis of the NSQIP database

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Postoperative complication rates for elderly women undergoing breast cancer surgery have not been well studied. We describe the postoperative complication rates of elderly (≥ 70 years) women with breast cancer and compare them with young (40–69 years) women.

Methods

Data were extracted from the National Surgical Quality Improvement Program database (2004–2014). We included women with invasive breast cancer who underwent surgery. Outcomes were 30-day postoperative morbidity and mortality (complications), which were compared between young and elderly women. Morbidity was categorized using the Surgical Risk Preoperative Assessment System (SURPAS) clusters.

Results

We identified 100,037 women of which 26.7% were elderly. Compared to young women, elderly women were more likely to have more comorbidities and undergo breast-conserving surgery, but less likely to undergo lymph node surgery, breast reconstruction, and neoadjuvant chemotherapy. While the 30-day overall morbidity rate was not significantly different between young and elderly women (3.9 vs. 3.8%, p = 0.2), elderly women did have significantly higher rates of pulmonary, cardiac (arrest and myocardial infarction), venous thromboembolic, and neurological morbidity. Specific morbidities that showed significantly lower rates among elderly women included wound disruption and deep and organ space surgical site infection. Any cause death was significantly higher in elderly compared to young women (0.2 vs. 0.05%, p < 0.001).

Conclusions

While some specific 30-day postoperative morbidities were more often seen in elderly women, the overall 30-day postoperative complication rate was very low. These data support the safety of breast cancer surgery in well-selected elderly patients.

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Abbreviations

ACS:

American College of Surgeons

ASA:

American Society of Anesthesiology

BMI:

Body mass index

BCS:

Breast- conserving surgery

CPT:

Current Procedural Terminology

ICD-9:

International Classification of Diseases Ninth Revision

IQR:

Interquartile range

NSQIP:

National Surgical Quality Program

PUF:

Participant Use Data File

STROBE:

Strengthening the Reporting of Observational Studies in Epidemiology

SURPAS:

Surgical Risk Preoperative Assessment System

y:

Years

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Author information

Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada

    Fernando A. Angarita, Sergio A. Acuna, Ahmad Elnahas, Subir Sutradhar, Timothy Jackson & Tulin D. Cil

  2. Division of General Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada

    Erin Cordeiro

  3. Division of General Surgery, University Health Network, 700 University Ave, OPG- 6th Floor, Toronto, ON, M5G 2M9, Canada

    Ahmad Elnahas, Timothy Jackson & Tulin D. Cil

  4. Division of General Surgery, Women’s College Hospital, Toronto, ON, Canada

    Tulin D. Cil

Authors
  1. Fernando A. Angarita
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  2. Sergio A. Acuna
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  7. Tulin D. Cil
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Correspondence to Tulin D. Cil.

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Angarita, F.A., Acuna, S.A., Cordeiro, E. et al. Thirty-day postoperative morbidity and mortality in elderly women with breast cancer: an analysis of the NSQIP database. Breast Cancer Res Treat 170, 373–379 (2018). https://doi.org/10.1007/s10549-018-4747-5

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  • DOI: https://doi.org/10.1007/s10549-018-4747-5

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