ArticleThe British journal of surgery2020
Effect of omission of surgery on survival in patients aged 80 years and older with early-stage hormone receptor-positive breast cancer.
Article in The British journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 17 citations in OpenAlex.
- Bridging the age gap in breast cancer: cluster randomized trial of two decision support interventions for older women with operable breast cancer on quality of life, survival, decision quality, and treatment choices.The British journal of surgery · 2021Trial
- De-Escalation of Treatment in Women Aged ≥80 Years with Breast Cancer: A Retrospective Analysis from Two Breast Centers.Current oncology (Toronto, Ont.) · 2025Article
- Healthcare delivery to elderly and unfit patients with breast disease and comorbidities under an outpatient regime: A report of a personal surgical technique named "Cut&Sew".Surgery open science · 2023Article
- The impact of geriatric characteristics and comorbidities on distant metastases and other cause mortality in older women with non-metastatic breast cancer treated with primary endocrine therapy.Breast cancer research and treatment · 2023Article
- Treatment and survival outcomes in older women with primary breast cancer: A retrospective propensity score-matched analysis.Breast (Edinburgh, Scotland) · 2022Article
- Differences in treatment and survival of older patients with operable breast cancer between the United Kingdom and the Netherlands - A comparison of two national prospective longitudinal multi-centre cohort studies.European journal of cancer (Oxford, England : 1990) · 2022Article
- How aging of the global population is changing oncology.Ecancermedicalscience · 2021Article
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundSurgery is increasingly being omitted in older patients with operable breast cancer in the Netherlands. Although omission of surgery can be considered in frail older patients, it may lead to inferior outcomes in non-frail patients. Therefore, the aim of this study was to evaluate the effect of omission of surgery on relative and overall survival in older patients with operable breast cancer.
methodsPatients aged 80 years or older diagnosed with stage I-II hormone receptor-positive breast cancer between 2003 and 2009 were selected from the Netherlands Cancer Registry. An instrumental variable approach was applied to minimize confounding, using hospital variation in rate of primary surgery. Relative and overall survival was compared between patients treated in hospitals with different rates of surgery.
resultsOverall, 6464 patients were included. Relative survival was lower for patients treated in hospitals with lower compared with higher surgical rates (90·2 versus 92·4 per cent respectively after 5 years; 71·6 versus 88·2 per cent after 10 years). The relative excess risk for patients treated in hospitals with lower surgical rates was 2·00 (95 per cent c.i. 1·17 to 3·40). Overall survival rates were also lower among patients treated in hospitals with lower compared with higher surgical rates (48·3 versus 51·3 per cent after 5 years; 15·0 versus 19·7 per cent after 10 years respectively; adjusted hazard ratio 1·07, 95 per cent c.i. 1·00 to 1·14).
conclusionOmission of surgery is associated with worse relative and overall survival in patients aged 80 years or more with stage I-II hormone receptor-positive breast cancer. Future research should focus on the effect on quality of life and physical functioning.
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