A study conducted by National Cancer Centre Singapore (NCCS) has shown that age per se is not a contraindication to breast cancer surgery, and such surgeries may be safely performed for women aged 80 years and above.
Led by Dr. Ong Kong Wee, Senior Consultant in the Division of Surgical Oncology, the team consists of Dr. Veronique Tan, Consultant, and Dr. Lee Chee Meng, Resident Doctor. The study explores the safety of breast cancer surgery in women aged 80 years and above.
A retrospective analysis was performed on 109 elderly women who underwent surgery in NCCS and Singapore General Hospital (SGH) from 2001 – 2010. Most patients were assessed to be fit for surgery under the American Society of Anesthesiologists (ASA) physical classification status with 75 per cent of patients having an ASA physical status of 1 or 2 .
Although approximately 80 percent of patients had 1 – 4 co-existing medical problems such as hypertension, dyslipidaemia and diabetes mellitus, there were no deaths recorded following the breast surgery. More than 60 per cent of patients recovered without any complications, while only 3 per cent developed major complications but recovered subsequently. The average length of stay in the hospital was 3 days.
"The results of this study are important as they dispel the misconception and fear among the public that surgery for elderly patients is unsafe and has a high complication rate", said Dr. Ong. "Surgery is the most important modality in the treatment of breast cancer. It also relieves symptoms in patients who have tumours that do not respond to other therapies. Elderly patients should not be deprived of such treatment options."
Dr. Veronique Tan, NCCS Consultant said, "Treatment options outside of surgery would only control the disease. The cancer cells may develop resistance to these treatments over time, and when patients require a salvage surgery later, it may result in even more complications with lower success rate."
Early detection and effective treatment is very important. For elderly patients such as 87 years old Mdm Tay Sai Eng who was diagnosed with stage II breast cancer, she was given surgery despite having active medical conditions, and she is now cancer-free. Dr. Ong added, "Surgery should always be considered in even among elderly patients and performed expeditiously."
Breast cancer is the top cancer among women in Singapore and an estimate of 1 in 16 Singaporean women will develop breast cancer by the age of 80 with a life-time risk of 6.5 per cent. The incidence rate is expected to rise with increasing life expectancy and an ageing population.