Breast reconstruction in older women: a growing request

Background

As the population ages, the treatment of breast cancer among elderly women is becoming increasingly common. Decisions regarding breast reconstruction require not only considerations of patients' age and comorbidities but also a need to balance life expectancy with quality of life.

Although fewer women at all ages are undergoing mastectomy, for those elderly women who undergo mastectomy, reconstruction options should be offered. Over the past years, increasing numbers of elderly women are electing post-mastectomy reconstruction.

Methods

Experience with women undergoing mastectomy from 2000 to March 2008 was reviewed. Patient demographics, indication for surgery and decision regarding immediate reconstruction were collected using retrospective analysis of medical records, with attention to women over the age of 60.

Results

During this time period, 153 (27%) of patients with breast cancer were 60 years or older. Approximately, one third (49 patients) required or elected mastectomy as primary treatment. Of the 49 women evaluated, 17 (28%) elected delayed implant-based breast reconstruction. No patients experienced major complications at the longest follow up.

Conclusion

Elderly women undergoing with mastectomy should be offered breast reconstruction as part of their treatment. Physicians and patients need to be educated regarding surgical options, the minimal associated morbidity and mortality, and excellent functional and cosmetic outcomes. With extended life expectancy, breast reconstruction enhances these aspects of quality of life. Future management guidelines should include breast reconstruction in the algorithm.