Abhishek Chatterjee1, Bryan Pyfer2, Brian Czerniecki1, Kari Rosenkranz3, Julia Tchou1, Carla Fisher1. 1. Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania. 2. Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. Electronic address: Bryan.j.pyfer.MED@dartmouth.edu. 3. Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Abstract
BACKGROUND: Relatively scarce outcomes research exists that compares early postoperative complications between breast conservation surgery (BCS) and simple mastectomy (SM). Such information would improve a surgeon's ability to provide informed consent when considering treatment options, especially for women with early stage breast cancer who have the option to receive either BCS or SM. MATERIALS AND METHODS: The National Surgical Quality Improvement Program database from years 2009-2012 was analyzed. For each treatment group, we used Current Procedural Terminology codes specific to the treatment modality with sentinel lymph node biopsy as an inclusion criteria. We excluded patients who received axillary lymphadenectomies, bilateral disease or symmetry procedures, and additional breast reconstructive surgery. We compared each group with chi square and two-sample t-tests to look for preoperative comorbidity differences, then used unadjusted odds ratios to compare postoperative complication rates. RESULTS: Inclusion and exclusion criteria provided 6682 patients in the BCS group and 3339 patients in the SM group. Baseline comorbid condition characteristics showed no clinical differences between groups except for diabetes (8.5% in SM versus 6.5% in BCS). Statistical analysis between each treatment modality revealed that the SM group had significantly higher wound complications, bleeding, infections, and overall complications than the BCS group. CONCLUSIONS: Although both BCS and SM options have low early postoperative complication rates when treating early stage breast cancer, BCS has fewer complications with regard to bleeding, wound complications and infections.
BACKGROUND: Relatively scarce outcomes research exists that compares early postoperative complications between breast conservation surgery (BCS) and simple mastectomy (SM). Such information would improve a surgeon's ability to provide informed consent when considering treatment options, especially for women with early stage breast cancer who have the option to receive either BCS or SM. MATERIALS AND METHODS: The National Surgical Quality Improvement Program database from years 2009-2012 was analyzed. For each treatment group, we used Current Procedural Terminology codes specific to the treatment modality with sentinel lymph node biopsy as an inclusion criteria. We excluded patients who received axillary lymphadenectomies, bilateral disease or symmetry procedures, and additional breast reconstructive surgery. We compared each group with chi square and two-sample t-tests to look for preoperative comorbidity differences, then used unadjusted odds ratios to compare postoperative complication rates. RESULTS: Inclusion and exclusion criteria provided 6682 patients in the BCS group and 3339 patients in the SM group. Baseline comorbid condition characteristics showed no clinical differences between groups except for diabetes (8.5% in SM versus 6.5% in BCS). Statistical analysis between each treatment modality revealed that the SM group had significantly higher wound complications, bleeding, infections, and overall complications than the BCS group. CONCLUSIONS: Although both BCS and SM options have low early postoperative complication rates when treating early stage breast cancer, BCS has fewer complications with regard to bleeding, wound complications and infections.
Authors: Leanne N Metcalfe; Adam M Zysk; Kiran S Yemul; Lisa K Jacobs; Elif E Oker; Howard R Underwood; Alastair M Thompson Journal: JAMA Surg Date: 2017-11-01 Impact factor: 14.766
Authors: Soo Yeon Baek; Jisun Kim; Il Yong Chung; Beom Seok Ko; Hee Jeong Kim; Jong Won Lee; Byung Ho Son; Sei-Hyun Ahn; Sae Byul Lee Journal: Breast Cancer Res Treat Date: 2020-09-15 Impact factor: 4.872