Expert: Ronald Levy, M.D. - 12/29/2010

Question
My aunt who just turned 101 has recently been diagnosed with breast cancer will need a mastectomy. We are concerned about her undergoing the surgery because of her age but also because she has an enlarged heart, and other heart related issued.  (Currently, she lives in a private apartment in an assisted living facility. She can remember things that occurred when she was growing up.)  Are there questions that we need to ask prior to the surgery?

Answer
The fact that she lived to 101 says something about her physiology. Age is not a contraindication to surgery. I think the more important question might be for the surgeon. Depending on the size and stage of the tumor, she might be better off with a more limited procedure. To use prostate in elderly men as an example, prostate cancer is very slow growing so if the patient is elderly, they often treat it nonoperatively going with the philosophy that the "patient will die with the cancer, not from the cancer" meaning that the risks of surgery are greater than the benefits considering that it is not likely that the tumor would grow large enough to cause problems before the patient died of natural causes. Depending on the type of breast cancer, some grow slowly and some are very aggressive. If it is aggressive, then mastectomy is the way to go. if it is slow growing, then a limited resection might be advisable. Your surgeon would know this. As for the anesthesia, they will obviously monitor her very well. They will likely  put her in the ICU overnight post-op just to be safe. As for questions to ask, there is nothing you really need to ask, they will ask you a lot of questions but feel free to voice any concerns you have.

Good Luck,

Ronald Levy, MD
PRofessor of Anesthesiology
UTMB-Galveston