• A A Lemij, W G van der Plas-Krijgsman, E Bastiaannet, J W S Merkus, T van Dalen, A J E Vulink, L van Gerven, O R Guicherit, E M H Linthorst-Niers, T E Lans, C C van der Pol, L Wyld, J L Morgan, PortieljeJ E AJEADepartment of Medical Oncology, Leiden University Medical Centre, Leiden, the Netherlands., N A de Glas, and G J Liefers.
• Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands.
• Br J Surg. 2022 Jun 14; 109 (7): 595-602.

BackgroundThe percentage of older patients undergoing surgery for early-stage breast cancer has decreased over the past decade. This study aimed to develop a prediction model for postoperative complications to better inform patients about the benefits and risks of surgery, and to investigate the association between complications and functional status and quality of life (QoL).MethodsWomen aged at least 70 years who underwent surgery for Tis-3 N0 breast cancer were included between 2013 and 2018. The primary outcome was any postoperative complication within 30 days after surgery. Secondary outcomes included functional status and QoL during the first year after surgery, as assessed by the Groningen Activity Restriction Scale and the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BR23 questionnaires. A prediction model was developed using multivariable logistic regression and validated externally using data from the British Bridging the Age Gap Study. Linear mixed models were used to assess QoL and functional status over time.ResultsThe development and validation cohorts included 547 and 2727 women respectively. The prediction model consisted of five predictors (age, polypharmacy, BMI, and type of breast and axillary surgery) and performed well in internal (area under curve (AUC) 0.76, 95 per cent c.i. 0.72 to 0.80) and external (AUC 0.70, 0.68 to 0.72) validations. Functional status and QoL were not affected by postoperative complication after adjustment for confounders.ConclusionThis validated prediction model can be used to counsel older patients with breast cancer about the postoperative phase. Postoperative complications did not affect functional status nor QoL within the first year after surgery even after adjustment for predefined confounders.© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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