Background: Nodular thyroid lesions are common among the population, especially there no consensus about the best surgical treatment options for geriatric breast cancer patients due to exclusion from clinical trials. Further, fear of complications due to increased age often plays an important role in the decision making that affect the choice of treatment offered to these patients. Methods: This is a clinical multi-institutional retrospective study that included 308 geriatric patients (>65y) with breast cancer, surgically treated at Menoufia University Hospital and Tanta Cancer Center, Egypt from the period between January 2010 to end of December 2019. Data on treatment, surgical complications, and tumor characteristics were collected and analyzed. Results: One or more complications were experienced by 41⋅6 % of the patients, predominantly they were minor wound complications as seroma or minor wound infections. Serious complications occurred in 11% of patients. The main risk factors for complications included age >75years old (p < 0.001 *: OR=2.65, CI95%:1.64-4.30), co-morbidity (P=0.029: OR=1.76, CI95%:1.06-2.93)) where two co-morbidities served as a risk factor in comparison to one morbidity (P=0.013: OR=2.17, CI95%: 1.17-4.03)) and More than two (P=0.039: OR=2.45, CI95%:1.03-5.85), and MRM surgery (P=0.029: OR=2.0, CI95%: 1.06-3.76). Conclusion: The incidence of serious postoperative complications is not high in elderly breast cancer patients. Aggressive surgical approaches, age more than 75 and multiple co-morbidity, are important factors affecting the incidence of early postoperative complications in these patients.