Perioperative Outcomes of Therapeutic Breast Surgery in the Elderly.

Dear Editor, Female Singaporeans currently have a life expectancy of 84.5 years1 and a lifetime risk of 6.5% of developing breast cancer.2 It is estimated that by the year 2050, 11.2% of the population will be aged more than 80 years.3 One in 16 women will develop breast cancer by the age of 80, and there will potentially be 1500 cases of newly diagnosed breast cancer among octogenarians each year. Surgery is curative in early breast cancer and various centres have reported no difference in the cancer specifi c survival rates of the elderly age group compared to their younger counterparts, 5 to 10 years after surgery for breast cancer.4,5 Surgery is also indicated in advanced breast cancer as a form of palliation in patients with fungating and bleeding tumours. Despite its therapeutic role, Lavelle et al6 found that the proportion of older women receiving surgery fell with increasing comorbidity and many clinicians still do not discuss surgical options with elderly patients. We wanted to objectively report the postsurgical mortality and morbidity of the very elderly, aged above 80 years in our institution. We also hoped to identify risk factors that may predict for a poorer outcome. To our knowledge, this is the fi rst study in an Asian population.