Breast cancer is on the rise and 48 percent of all breast cancers occur in women older than 65, but very few of them choose to have breast reconstruction.
A new study from Wake Forest Baptist Medical Center sought to determine if breast reconstruction after mastectomy is safe for older women. The answer is yes.
"The removal of a breast has implications for the psychological, social and sexual well-being of the patient, establishing the need that reconstruction should be offered," said Marissa Howard-McNatt, M.D., assistant professor of surgery at Wake Forest Baptist. "However, little is known about rates of reconstruction in elderly women after breast cancer."
The study appears in the December issue of The American Surgeon journal. Howard-McNatt and colleagues reviewed data from patients treated at Wake Forest Baptist over a 10-year period, evaluating 89 women over age 60 who had undergone mastectomy and reconstruction.
What they determined from the study, said lead author Howard-McNatt, is that breast reconstruction is safe, feasible and well tolerated for these patients though they are not as likely to choose this option. "Generally, breast cancer in the elderly is less aggressive than in younger patients. Life expectancy can still be substantial -- 16 years for a 70-year-old and greater than six years for an otherwise healthy 80-year-old."
She cautions that women with co-morbid conditions such as coronary artery disease, diabetes and respiratory illnesses may be limited in their choices after a mastectomy. In treating older women, it's important to understand the biology of the disease, she said, and the impact co-morbidities have on survival.
As the population ages and women's overall health continues to improve, the number of women older than 65 is predicted to nearly double by 2050. "More patients are candidates for aggressive breast cancer therapy," Howard-McNatt said. "The safety of reconstruction, as well as increased life expectancy and healthier lifestyles, makes breast reconstruction desirable at any age."
Co-authors include Clay Forsberg, M.D., Edward Levine, M.D., Anthony DeFranzo, M.D., Malcolm Marks, M.D., and Lisa David, M.D., all of Wake Forest Baptist.
- Howard-McNatt, Marissa; Forsberg, Clay; Levine, Edward A.; DeFranzo, Anthony; Marks, Malcolm; David, Lisa. Breast Cancer Reconstruction in the Elderly. The American Surgeon, 2011; 77 (12): 1640-1643(4) [link]
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