Tammy Ju, Cecilia Rossi, Andrew Sparks, Claire Edwards, Anita McSwain, Christine Teal.
Objectives: The purpose of this study is to determine if there is an increased risk of complications following mastectomies associated with advanced age.
Materials and Methods: The ACS-NSQIP database was queried from 2010 to 2015 using a CPT code for mastectomy and complications were identified as defined by the database. Univariate analyses were performed using a binary outcome variable (complication present or not) by age decade. Multivariable logistic regression analysis was performed using decade 6 (age 60-69) as the reference group. P-value<0.05 was considered statistically significant.
Results: 4,854 patients met inclusion criteria, ages 18 to 90+. Univariate analyses for the presence of a postoperative complication by age decade showed no statistical difference except for wound infections (p<0.01). On multivariable analysis, the odds of having a postoperative complication is 1.4 times higher in obese patients (p<0.01,95%CI:1.1-1.8) and 1.4 times higher in smokers (p<0.01,95%CI:1.1-1.9). Complications are 3.5 times higher in patients who are not of fully independent functional status (p<0.0001,95%CI:2.3-5.8) and 5.9 times higher for dialysis patients (p<0.001,95%CI:2.3-15). Non-fully independent functional status also increased risk for mortality (p<0.05,OR=8.7,95%CI:1.5-49.6). Patients ages 90 or older were 3.4 times more likely to have a wound infection (p<0.05,95%CI:1.3-9.0).
Conclusion: There is no increased overall risk of a postoperative complication within 30 days of mastectomy due to the age of the patient. However, patients 90 years of age or older are at higher risk for wound infections. Our study suggests elderly breast cancer patients should not be excluded from undergoing a mastectomy solely based on their age.View pdf