Operating on frail, elderly nursing home residents who are suffering from breast cancer may not be the best course of action, according to a new study.
Analyzing a decade’s worth of data from nursing homes, researchers with UC San Francisco noted that residents typically saw higher mortality rates and hospital readmission, alongside a loss of independence, following the procedure. About 58% of women who stayed in a nursing home for 90 days following breast cancer surgery experienced “significant functional decline” in the year that followed, according to the study, published Wednesday in JAMA Surgery.
Authors note that surgery may not always be the first course of action. Nursing homes should help tailor care plans to each individual, offering alternative options, such as hormonal therapy and management of breast cancer symptoms.
“Surgery often cures the cancer, but can have a negative impact on elderly patients’ everyday activities and worsen their quality of life,” lead author Victoria Tang, M.D., assistant professor of geriatrics and of hospital medicine at UCSF, said in a press release.
Breast cancer surgery is the most common cancer operation performed on nursing home residents (61%), the study notes. Researchers conducted the study by analyzing Medicare claims data from 2003 to 2013 for nursing homes. It included nearly 6,000 women ages 67 and older who stayed in a facility for at least 90 days, and underwent inpatient breast cancer surgery. About 61% received the most invasive treatment, known as axillary lymph node dissection with lumpectomy or mastectomy.