Complications in patients with unilateral breast cancer who undergo contralateral prophylactic mastectomy versus unilateral mastectomy

Surgery. 2018 Dec;164(6):1347-1350. doi: 10.1016/j.surg.2018.05.044. Epub 2018 Jul 20.

Abstract

Background: The rate of contralateral prophylactic mastectomy has been increasing among patients with unilateral breast cancer. There remains a paucity of data regarding the impact of contralateral prophylactic mastectomy on duration of stay and complications requiring reoperation within 90 days of operation.

Methods: We reviewed the medical records of female unilateral breast cancer patients who underwent a mastectomy at a large academic institution between July 2013 and July 2016 to determine the effect of contralateral prophylactic mastectomy on complications and hospital stay.

Results: A total of 471 patients were included in this cohort, 276 (58.6%) of whom had contralateral prophylactic mastectomy. The median patient age was 52 years (range 22-90) and median tumor size was 1.1 cm (range 0-14.6 cm). There were 52 patients (11.0%) who had complications resulting in reoperation within 90 days, including 18 instances of bleeding complications (3.8%), 9 infections (1.9%), 18 thrombosis/necrosis of flaps (3.8%), 17 skin breakdown/wound complications (3.6%), 2 seromas (0.4%), and 2 implant ruptures (0.4%). The reoperation rate did not differ between patients undergoing contralateral prophylactic mastectomy and those who opted for unilateral mastectomy (11.2% vs 10.8%, respectively; P = .99). Median duration of hospital stay for the overall cohort was 2 days. Contralateral prophylactic mastectomy was associated with a greater hospital stay than unilateral mastectomy (median 3 vs 2 days; P < .001) and was a predictor of stays ≥2 days (odds ratio = 2.369; 95% confidence interval: 1.197-4.688; P = .013) independent of reconstruction and other factors associated with contralateral prophylactic mastectomy.

Conclusion: Compared to unilateral mastectomy, contralateral prophylactic mastectomy was associated with an increased hospital stays but not a greater 90-day reoperation rate for complications.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / surgery*
  • Connecticut / epidemiology
  • Female
  • Humans
  • Length of Stay
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Prophylactic Mastectomy / adverse effects*
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Young Adult