Departmental Bulletin Paper 当院における80歳以上の高齢者乳癌手術症例の検討

寺田, 好孝  ,  森, 毅  ,  北村, 美奈  ,  冨田, 香  ,  河合, 由紀  ,  加藤, 久尚  ,  坂井, 幸子  ,  梅田, 朋子  ,  竹林, 克士  ,  植木, 智之  ,  三宅, 亨  ,  飯田, 洋也  ,  貝田, 佐知子  ,  赤堀, 浩也  ,  山口, 剛  ,  園田, 寛道  ,  清水, 智治  ,  谷, 眞至

30 ( 1 )  , pp.42 - 45 , 2017-03-03 , 滋賀医科大学雑誌編集委員会
Breast cancer is the most common cancer in women in Japan, and it has been on the rise for several years. Elderly breast cancer patients have also been increasing. Surgical treatment is recommended for elderly breast cancer patients without metastases as applied in younger age groups in the clinical practice guidelines of Japanese Breast Cancer Society, however elderly breast cancer patients are frequently undertreated. We reviewed 19 primary breast cancer patients at age 80 over who underwent surgical treatment at our hospital from 2011 to 2015. The median age of at diagnosis was 82 years. Breast-conserving surgery was performed in 10 patients (without postoperative radiation therapy in all cases), mastectomy was performed in 9 patients. Fourteen patients had sentinel lymph node biopsy, and 5 patients had axillary lymph node dissection (including 2 patients of sentinel lymph node positive cases). Three patients had stage 0, 8 stage I, 4 stage IIA, 1 stage IIB, 1 stage IIIC, and 2 stage IV. There were 10 luminal A-like, 2 luminal B-like(HER2 negative), 2 luminal B-like(HER2 positive), 4 HER2 positive(non-luminal), and 1 TN (triple negative) in molecular subtypes. Seventeen patients had co-morbidities and 2 patients had a history of other cancers. Postoperative complications were 1 pneumothorax and 1 urinary tract infection. Regarding postoperative adjuvant therapy, 11 of 12 hormone receptor positive patients received hormone therapy, 2 of the 6 HER2 positive patients received anti-HER2 therapy, and 5 patients received adjuvant chemotherapy (oral anticancer agents were used in all cases), but 4 patients required dose reduction or discontinuation. Four patients were observed without treatment. Elderly people breast cancer patients often had co-morbidities, however standard surgical treatment was performed safely. It is difficult for elderly breast cancer patients to receive standard adjuvant chemotherapy in some cases, therefore important to undergo standard surgical treatment.

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