PHẪU THUẬT TỐI THIỂU TRONG UNG THƯ VÚ GIAI ĐOẠN SỚM Ở NGƯỜI CAO TUỔI TẠI BỆNH VIỆN THỐNG NHẤT CÂN BẰNG GIỮA KIỂM SOÁT BỆNH VÀ CHẤT LƯỢNG SỐNG

Abstract

Background: Breast cancer has emerged as a major health and social burden in the context of population aging. Older patients often present with multiple comorbidities, leading to more complex treatments. Domestic data on breast cancer surgery in the elderly remain limited. Methods: A cross-sectional descriptive study was conducted in 57 women aged ≥60 years with stage I–II breast cancer (cT1–2, cN0–1, cM0) who underwent surgery at Thong Nhat Hospital 08/2021 – 08/2025. Results: The mean age was 69.8 ± 7.4 years, mean BMI 23.3 ± 3.0 kg/m², and median Charlson Comorbidity Index (CCI) was 3. The main presenting symptom was a palpable mass (91.2%). Histology showed invasive ductal carcinoma in 73.7% and invasive lobular carcinoma in 15.8%. ER/PR positivity was observed in more than 65%. Mastectomy accounted for 94.7%, sentinel lymph node biopsy 59.6%, and axillary lymph node dissection 40.4%. Early complications occurred in 12.3% (infection, delayed wound healing), and late complications included lymphedema (14.0%) and chronic pain (7.0%). Major complications were 7.0%, with no 30-day mortality. These findings are consistent with international data, indicating that surgery is safe and provides effective disease control in elderly patients. Conclusion: Surgery for early-stage breast cancer in patients aged ≥60 years is safe, with low complication rates and favorable OS and DFS. Individualized surgical decision-making (particularly regarding axillary management) and integration of geriatric assessment are essential to optimize treatment and quality of life.