ArticleAnnals of surgical oncology2021
Mortality in Older Patients with Breast Cancer Undergoing Breast Surgery: How Low is "Low Risk"?
Article in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic Tools for Older Women with Breast Cancer: A Systematic Review.Medicina (Kaunas, Lithuania) · 2023Pooled it
- A Single-Center 11-Year Experience of Surgical Management of Breast Cancer in Patients Aged 90 Years or Older.Cureus · 2025Article
- A novel machine learning prediction model for metastasis in breast cancer.Cancer reports (Hoboken, N.J.) · 2024Article
- Systemic inflammation in older patients with breast cancer: the missing point in geriatric evaluations to sharpen survival prediction.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2022Article
- 22nd Annual Virtual Meeting of the American Society of Breast Surgeons: Science, Innovation, and Practice Changes.Annals of surgical oncology · 2021Article
- Age at Breast Cancer Diagnosis and Short-Term Postoperative Outcomes for Women Treated in a Universal Health System.Cancer control : journal of the Moffitt Cancer CenterArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundBreast surgery carries a low risk of postoperative mortality. For older patients with multiple comorbidities, even low-risk procedures can confer some increased perioperative risk. We sought to identify factors associated with postoperative mortality in breast cancer patients ≥70 years to create a nomogram for predicting risk of death within 90 days.
methodsPatients diagnosed with nonmetastatic invasive breast cancer (2010-2016) were selected from the National Cancer Database. Unadjusted OS was estimated using the Kaplan-Meier method. Multivariate logistic regression was used to estimate the association of age and surgery with 90-day mortality and to build a predictive nomogram.
resultsAmong surgical patients ≥70 years, unadjusted 90-day mortality increased with increasing age (70-74 = 0.4% vs. ≥85 = 1.6%), comorbidity score (0 = 0.5% vs. ≥3 = 2.7%), and disease stage (I = 0.4% vs. III = 2.7%; all p < 0.001). After adjustment, death within 90 days of surgery was associated with higher age (≥85 vs. 70-74: odds ratio [OR] 3.16, 95% confidence interval [CI] 2.74-3.65), comorbidity score (≥3 vs. 0: OR 4.79, 95% CI 3.89-5.89), and disease stage (III vs. I: OR 4.30, 95% CI 3.69-5.00). Based on these findings, seven variables (age, gender, comorbidity score, facility type, facility location, clinical stage, and surgery type) were selected to build a nomogram; estimates of risk of death within 90 days ranged from <1 to >30%.
conclusionsBreast operations remain relatively low-risk procedures for older patients with breast cancer, but select factors can be used to estimate the risk of postoperative mortality to guide surgical decision-making among older women.
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