Impact of comorbidities on surgical outcomes following mastectomy in elderly breast cancer patients: An analysis of the NSQIP database.

Abstract

88 Background: Approximately 4% of women age 70 will develop breast cancer during the next ten years. There is limited data on surgical outcomes in elderly patients undergoing treatment for breast cancer. This study examines complications following mastectomy in elderly patients and determines how comorbidities impact those outcomes. Methods: The American College of Surgeons National Surgery Quality Improvement Program database was used to examine complications and comorbidities in breast cancer patients 70 or older undergoing mastectomy from 2007-2012. The relationship between complication and comorbidity was characterized using descriptive statistics and Wilcoxon rank-sum test. Variable frequencies were compared using Chi-square or Fisher’s exact test with a statistically significant two-sided p-value set at 0.05. Results: We identified 12,026 patients 70 or older who underwent mastectomy. The 30-day overall morbidity rate was 4.22%. Myocardial infarction (MI) was associated with history of bleeding disorder and cerebral vascular accident (CVA) (P < 0.05). Prior CVA, transient ischemic attack and MI were associated with post-operative CVA (p < 0.05). Chronic obstructive pulmonary disease and steroid use impacted post-operative pneumonia (p < 0.05). Bleeding disorder, hypertension, and steroid use impacted urinary tract infection occurrence (p < 0.05). Diabetes increased the rate of wound dehiscence (p = 0.001). Conclusions: The 30-day morbidity rate of elderly breast cancer patients undergoing mastectomy is low. Although the complication rate is low, certain comorbidities increase the risk of specific complications. Appropriate measures should be taken to optimize comorbidities in elderly patients to further minimize adverse outcomes.