Abstract
IntroductionElderly and medically unfit patients make up a small but significant proportion of breast cancer patients. MethodsA prospective study of breast cancer wide local excisions (WLE) performed under local anaesthesia (LA) from Mar 2008 to Apr 2011. Results17 patients were included, with average age of 81 years (range 59 – 94 years). 10 patients had American Society of Anaesthesia (ASA) grade 3 and 7 patients had ASA grade 2. Mini mental state examination (MMSE) range was 8-10 (average 8.75). Preoperative Portsmouth Physiologic and Operative Severity Score for enumeration of Mortality and Morbidity (PPOSSUM), score predicted morbidity at 28.5 % (range 15 – 60%) and mortality at 1.8 % (range 0.1 – 6.1%). The observed morbidity was 5.8 % and mortality was 0%. Tumor size was 13-47mm (median 26mm). 10 patients were oestrogen receptor (ER) negative and 7 were positive. 100% disease free survival has been observed. The follow-up range was 8-54 months (median 39 months). ConclusionsWLE of breast cancer under LA is a useful option. All patients in this selected ‘unfit’ group were treated as day cases. All patients currently remain disease free. DisclosureAll authors have declared no conflicts of interest.
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