论文部分内容阅读
Women with breast cancer of all ages deserve equal access and a high standard of care.There is growing concern in the UK that elderly patients may not be offered the best care possible because of their age (Breast Cancer Research UK 2006).There have been studies claiming that there is no significant difference in outcome in elderly patients having primary hormonal treatment alone versus those managed surgically.However, our experience suggests that breast cancer patients aged over 70 managed surgically do better than those treated with endocrine therapy alone.We reviewed the time to progression of patients diagnosed with breast cancer who were managed conservatively and compared them with those treated surgically with intent to cure.This is an ongoing retrospective case note based study of consecutive patients aged 70 or more at the time of initial diagnosis managed at the Prince Philip Hospital in Llanelli (Southwest Wales) from 2003 to 2008.Patients have either had conservative management or surgery with intent to cure.The average age for the study population (n=190) is 79.2 years (Range 70-96).97.4% of the patients underwent triple assessment at presentation.64.2% of the patients (n=122) underwent surgery with the intent tocure.11 patients (5.8%) had immediate postoperative complication which was appropriately managed.Post operative surgical mortality rate is 0.5% (n=1).In those managed conservatively (n=68), the progression rate was 18.6% (average follow up=23.6 months) in comparison to a 6.25% progression rate in those treated surgically with an intent to cure (average follow up=28.4 months).Our results support the hypothesis that older patients fit for surgery should be treated no differently from younger patients.