Annals of Surgical Oncology

, Volume 22, Issue 11, pp 3474–3480 | Cite as

The Effect of Contralateral Prophylactic Mastectomy on Perioperative Complications in Women Undergoing Immediate Breast Reconstruction: A NSQIP Analysis

  • Amanda K. Silva
  • Brittany Lapin
  • Katharine A. Yao
  • David H. Song
  • Mark Sisco
Breast Oncology

Abstract

Background

Women with breast cancer are increasingly choosing to undergo contralateral prophylactic mastectomy (CPM) despite questionable survival benefit and limited data on added risks. Little is known about differences in perioperative complications between women who undergo bilateral mastectomy (BM) versus unilateral mastectomy (UM) with reconstruction.

Methods

The American College of Surgeons National Surgery Quality Improvement Program Participant Use Files (2005–2013) were used to identify women with unilateral breast cancer who underwent UM or BM with reconstruction. Adjusted 30-day complications were compared between UM and BM groups using logistic regression models.

Results

A total of 20,501 patients were identified, of whom 35.3 % underwent BM. Of these, 84.3 % had implant reconstruction and 15.7 % had autologous reconstruction. For all women, BM was associated with longer hospital stays (adjusted odds ratio [aOR] 1.98–2.09, p < 0.001) and a higher transfusion rate than UM (aOR 2.52–3.06, p < 0.001). BM with implant reconstruction was associated with a modestly increased reoperation rate (aOR 1.15, p = 0.029). BM with autologous reconstruction was associated with a higher wound disruption rate (aOR 2.51, p = 0.015). Surgical site infections, prosthesis failure, and medical complications occurred at similar rates in UM and BM groups.

Conclusions

CPM is associated with significant increases in some, but not all, surgical site complications. CPM does not increase the likelihood of medical complications, which are generally infrequent.

Keywords

Breast Reconstruction Contralateral Prophylactic Mastectomy Bilateral Mastectomy Unilateral Breast Cancer Current Procedural Terminology Code 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Disclosure

The authors declare no conflict of interest.

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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Amanda K. Silva
    • 1
  • Brittany Lapin
    • 2
  • Katharine A. Yao
    • 3
  • David H. Song
    • 1
  • Mark Sisco
    • 4
  1. 1.Section of Plastic and Reconstructive SurgeryUniversity of Chicago HospitalsChicagoUSA
  2. 2.Center for Biomedical Research InformaticsNorthShore University HealthSystem Research InstituteEvanstonUSA
  3. 3.Division of Surgical OncologyNorthShore University HealthSystemEvanstonUSA
  4. 4.Division of Plastic and Reconstructive SurgeryNorthShore University HealthSystemEvanstonUSA

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