STUDY REVEALS BREAST SURGERY AS A DEFINITIVE AND SAFE TREATMENT FOR ELDERLY PATIENTS WITH BREAST CANCER

ØResults show that 97% per cent of elderly patients aged above 80 years recover without major complications after surgery

ØNo deaths following surgery despite co-existing medical problems in 80 per cent of patients

Singapore, 05 September 2014 – A study conducted by National Cancer Centre Singapore (NCCS) has shown that age per se is not a contraindication to breast cancer surgery, and such surgeries may be safely performed for women aged 80 years and above. Led by Dr Ong Kong Wee, Senior Consultant in the Division of Surgical Oncology, the team consists of Dr Veronique Tan, Consultant, and Dr Lee Chee Meng, Resident Doctor. The study explores the safety of breast cancer surgery in women aged 80 years and above.

A retrospective analysis was performed on 109 elderly women who underwent surgery in NCCS and Singapore General Hospital (SGH) from 2001 – 2010. Most patients were assessed to be fit for surgery under the American Society of Anesthesiologists (ASA) physical classification status with 75 per cent of patients having an ASA physical status of 1 or 21.  

Although approximately 80 per cent of patients had 1 – 4 co-existing medical problems such as hypertension, dyslipidaemia and diabetes mellitus, there were no deaths recorded following the breast surgery. More than 60 per cent of patients recovered without any complications, while only 3 per cent developed major complications but recovered subsequently. The average length of stay in the hospital was 3 days.

“The results of this study are important as they dispel the misconception and fear among the public that surgery for elderly patients is unsafe and has a high complication rate”, said Dr Ong. “Surgery is the most important modality in the treatment of breast cancer. It also relieves symptoms in patients who have tumours that do not respond to other therapies. Elderly patients should not be deprived of such treatment options.”

Dr Veronique Tan, NCCS Consultant said, “Treatment options outside of surgery would only control the disease. The cancer cells may develop resistance to these treatments over time, and when patients require a salvage surgery later, it may result in even more complications with lower success rate.”

Early detection and effective treatment is very important. For elderly patients such as 87 years old Mdm Tay Sai Eng who was diagnosed with stage II breast cancer, she was given surgery despite having active medical conditions, and she is now cancer-free. Dr Ong added, “Surgery should always be considered in even among elderly patients and performed expeditiously.”

Breast cancer is the top cancer among women in Singapore and an estimate of 1 in 16 Singaporean women will develop breast cancer by the age of 80 with a life-time risk of 6.5 per cent. The incidence rate is expected to rise with increasing life expectancy and an ageing population.

1American Society of Anesthesiologists (ASA) physical classification status is a universally accepted score used to assess a patient’s fitness for surgery. ASA Physical Status 1 refers to a normal healthy patient while Status 2 refers to a patient with mild systemic disease.  https://www.asahq.org/clinical/physicalstatus.htm

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

For more information, please contact:

National Cancer Centre Singapore
Mr Edwin Yong
Tel: +65 6236-9465
Email: edwin.yong.c.y@nccs.com.sg 

A patient profile is enclosed in Annex A. Patient is available for interview upon request.

About National Cancer Centre Singapore

National Cancer Centre Singapore (NCCS) provides a holistic and multidisciplinary approach to cancer treatment and patient care. We treat almost 70 per cent of the public sector oncology cases, and they are benefiting from the sub-specialization of our clinical oncologists. NCCS is also accredited by the US-based Joint Commission International for its quality patient care and safety.
To deliver among the best in cancer treatment and care, our clinicians work closely with our scientists who conduct robust cutting-edge clinical and translational research programmes which have been internationally recognised. NCCS strives to be a global leading cancer center, and shares its expertise and knowledge by offering training to local and overseas medical professionals. www.nccs.com.sg 

Annex A

Patient Profile – Mdm Tay Sai Eng, 87 years old, converse in Mandarin

A mother of 5, Mdm Tay was diagnosed with stage II breast cancer in November 2012. She had noticed a lump in her right breast but only decided to consult a doctor after a six-month lapse. Surgery was suggested as a viable treatment but she declined and requested for other treatment options instead. Her main concern was the safety of breast cancer surgery in view of her having pre-existing active medical conditions of diabetes (diet controlled), hypertension, hyperlipidemia and cervical spondylosis.

Mdm Tay was then treated with a drug commonly used for early stage breast cancer about 6 months. Unfortunately her cancer cells did not respond well and she experienced multiple discomforts and side effects throughout the treatment. She was then referred to Dr Ong and her family members were immediately counselled on the possibility of having a breast surgery. With the confidence and advice from Dr Ong, Mdm Tay went ahead with the surgery despite mixed feelings within the family.

The breast surgery was carried out in May 2013. Since then she has been followed up by the NCCS medical team on her condition. Apart from experiencing minor post operation issues, such as a Seroma (the build-up of clear bodily fluids in a place on your body where tissue has been removed by surgery; common after breast sugery), Mdm Tay has recovered well from the surgery.

Life after breast cancer surgery has been fulfilling and she has resumed her painting and calligraphy sessions, watches her favourite dramas, and even finds the energy to occasionally cook some favourite dishes for her family. Mdm Tay said, "I appreciate what NCCS specialists have done for me. They gave me hope and they gave me a new life. Every day I can look forward to the future, spending time with my family and friends."

 
From left to right: Mr David Cheng (Caregiver and son of Mdm Tay), Mdm Tay Sai Eng, Dr Ong Kong Wee, Dr Veronique Tan, Dr Lee Chee Meng.