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Cancers 2019, 11(2), 253; https://doi.org/10.3390/cancers11020253

Trending Towards Safer Breast Cancer Surgeries? Examining Acute Complication Rates from A 13-Year NSQIP Analysis

1
Department of Surgery, Tufts Medical Center, 800 Washington Street, South Building, 4th Floor, Boston, MA 02111, USA
2
Department of Clinical and Translational Science, Tufts University Sackler Graduate School, 136 Harrison Ave #813, Boston, MA 02111, USA
3
Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, USA
*
Author to whom correspondence should be addressed.
Received: 24 December 2018 / Revised: 29 January 2019 / Accepted: 18 February 2019 / Published: 21 February 2019
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Abstract

As breast cancer surgery continues to evolve, this study highlights the acute complication rates and predisposing risks following partial mastectomy (PM), mastectomy(M), mastectomy with muscular flap reconstruction (M + MF), mastectomy with implant reconstruction (M + I), and oncoplastic surgery (OPS). Data was collected from the American College of Surgeons NSQIP database (2005–2017). Complication rate and trend analyses were performed along with an assessment of odds ratios for predisposing risk factors using adjusted linear regression. 226,899 patients met the inclusion criteria. Complication rates have steadily increased in all mastectomy groups (p < 0.05). Cumulative complication rates between surgical categories were significantly different in each complication cluster (all p < 0.0001). Overall complication rates were: PM: 2.25%, OPS: 3.2%, M: 6.56%, M + MF: 13.04% and M + I: 5.68%. The most common predictive risk factors were mastectomy, increasing operative time, ASA class, BMI, smoking, recent weight loss, history of CHF, COPD and bleeding disorders (all p < 0.001). Patients who were non-diabetic, younger (age < 60) and treated as an outpatient all had protective OR for an acute complication (p < 0.0001). This study provides data comparing nationwide acute complication rates following different breast cancer surgeries. These can be used to inform patients during surgical decision making. View Full-Text
Keywords: breast conservation surgery; oncoplastic surgery; mastectomy; mastectomy with reconstruction; complication rate; comorbidity; trend analysis breast conservation surgery; oncoplastic surgery; mastectomy; mastectomy with reconstruction; complication rate; comorbidity; trend analysis
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Jonczyk, M.M.; Jean, J.; Graham, R.; Chatterjee, A. Trending Towards Safer Breast Cancer Surgeries? Examining Acute Complication Rates from A 13-Year NSQIP Analysis. Cancers 2019, 11, 253.

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