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.
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