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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2015

01-12-2015 | Breast Oncology

Reoperation for Complications after Lumpectomy and Mastectomy for Breast Cancer from the 2012 National Surgical Quality Improvement Program (ACS-NSQIP)

Authors: Zahraa Al-Hilli, MD, Kristine M. Thomsen, BA, Elizabeth B. Habermann, PhD, James W. Jakub, MD, Judy C. Boughey, MD

Published in: Annals of Surgical Oncology | Special Issue 3/2015

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Abstract

Background

Hospital readmissions and reoperations are quality indicators of patient care. In 2012, the National Surgical Quality Improvement Program (ACS-NSQIP) began reporting details regarding unplanned reoperations within 30 days of initial procedure. The main objective of this study was to identify reoperation rates as a result of complications and evaluate complications by type of breast surgery.

Methods

Patients who underwent surgery for breast cancer were identified from the 2012 ACS-NSQIP Participant User File. Breast procedures were categorized as mastectomy or lumpectomy, each with or without immediate breast reconstruction (IBR). All reoperations and complication-related reoperations were categorized on the basis of procedure and diagnosis codes, and rates were compared by breast procedure by Chi square tests.

Results

Of 18,500 patients, 781 (4 %) required an unplanned reoperation within 30 days (single reoperation in 747, 2+ reoperations in 34). Mean time to first reoperation was 13.4 days and varied by procedure. A majority (73 %) of ACS-NSQIP coded unplanned reoperations were due to complications. Rates of reoperation due to complication were highest in mastectomy with IBR (7 %). Most common complications requiring reoperation were bleeding, followed by infection and wound-related problems.

Conclusions

Unplanned reoperations after breast cancer surgery are more frequent after mastectomy with IBR than other breast operations. Bleeding is the most common complication requiring reoperation.
Literature
1.
2.
El-Tamer MB, Ward BM, Schifftner T, Neumayer L, Khuri S, Henderson W. Morbidity and mortality following breast cancer surgery in women: national benchmarks for standards of care. Ann Surg. 2007;245:665–71.PubMedPubMedCentralCrossRef
3.
Mansel RE, Fallowfield L, Kissin M, et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC trial. J Natl Cancer Inst. 2006;98:599–609.PubMedCrossRef
4.
Garwood ER, Moore D, Ewing C, et al. Total skin-sparing mastectomy: complications and local recurrence rates in 2 cohorts of patients. Ann Surg. 2009;249:26–32.PubMedCrossRef
5.
Degnim AC, Throckmorton AD, Boostrom SY, et al. Surgical site infection after breast surgery: impact of 2010 CDC reporting guidelines. Ann Surg Oncol. 2012;19:4099–103.PubMedPubMedCentralCrossRef
6.
7.
Warren JL, Riley GF, Potosky AL, Klabunde CN, Richter E, Ballard-Barbash R. Trends and outcomes of outpatient mastectomy in elderly women. J Natl Cancer Inst. 1998;90:833–40.PubMedCrossRef
8.
Fischer JP, Wes AM, Tuggle CT, Serletti JM, Wu LC. Risk analysis and stratification of surgical morbidity after immediate breast reconstruction. J Am Coll Surg. 2013;217:780–7.PubMedCrossRef
9.
Gart MS, Smetona JT, Hanwright PJ, et al. Autologous options for postmastectomy breast reconstruction: a comparison of outcomes based on the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg. 2013;216:229–38.PubMedCrossRef
10.
Fischer JP, Nelson JA, Au A, Tuggle CT 3rd, Serletti JM, Wu LC. Complications and morbidity following breast reconstruction—a review of 16,063 cases from the 2005–2010 NSQIP datasets. J Plast Surg Hand Surg. 2014;48:104–14.PubMedCrossRef
11.
Ogunleye AA, De Blacam C, Curtis MS, Colakoglu S, Tobias AM, Lee BT. An analysis of delayed breast reconstruction outcomes as recorded in the American College of Surgeons National Surgical Quality Improvement Program. J Plast Reconstr Aesthetic Surg. 2012;65:289–95.CrossRef
Metadata
Title
Reoperation for Complications after Lumpectomy and Mastectomy for Breast Cancer from the 2012 National Surgical Quality Improvement Program (ACS-NSQIP)
Authors
Zahraa Al-Hilli, MD
Kristine M. Thomsen, BA
Elizabeth B. Habermann, PhD
James W. Jakub, MD
Judy C. Boughey, MD
Publication date
01-12-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue Special Issue 3/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4741-7

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