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CANCER-PATIENTS-SURGERY
Physically weak breast cancer patients face higher risk of death after
surgery: study
SAN FRANCISCO, Aug 29, 2018 (BSS/XINHUA) – Senior breast cancer patients
who are physically weak have a higher rate of mortality and hospital
readmission after they undergo surgery, a study by University of California
San Francisco (UCSF) said Wednesday.
Using 2003-2013 claims from all U.S. Medicare nursing homes, UCSF
researchers studied data of 5,969 women aged 67 and older who had lived in a
nursing home for at least 90 days and who had undergone inpatient breast
cancer surgery.
The researchers found that 58 percent of them experienced significant
functional decline one year after surgery.
About 16 percent of the patients reported a higher rate of hospital
readmission 30 days after surgery, and 3.2 percent risked all-cause mortality
at 30 days, the researchers said.
An overall 31 percent of the frail breast cancer patients died within one
year after surgery, according to the study published in the Journal of the
American Medical Association (JAMA) Surgery.
“Surgery often cures the cancer, but can have a negative impact on elderly
patients’ everyday activities and worsen their quality of life,” said the
study’s lead author Victoria Tang, assistant professor of geriatrics at UCSF.
The elderly women suffering breast cancer who lived in nursing homes and
experienced functional impairment in their daily activities prior to
treatment had the highest rates of one-year mortality.
Around 61 seniors living in the nursing homes received the most invasive
treatment, such as axillary lymph node dissection with lumpectomy or
mastectomy, but “the highest mortality rate was associated with the least
invasive procedure, lumpectomy, which appeared to be performed in the sickest
patients,” Tang said.
Considering the high mortality rate, the UCSF researchers do not recommend
surgery treatment for long-term nursing home residents, because the risks of
harm may outweigh the benefit in this vulnerable population.
They prefer to suggest the senior breast cancer patients, many of whom
have a limited life expectancy, be treated with hormonal therapies, such as
endocrine therapy, radiotherapy, or symptom management only.
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