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Operative Risks Associated with Contralateral Prophylactic Mastectomy: A Single Institution Experience

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The purpose of this study was to determine if newly diagnosed breast cancer patients undergoing contralateral prophylactic mastectomy (CPM) experience more complications than patients undergoing unilateral mastectomy (UM).

Methods

A total of 600 patients underwent either UM or CPM between January 2009 and March 2012 for unilateral breast cancer. Operative complications were classified as minor (aspirations, infection requiring antibiotics, partial flap and nipple necrosis, minor bleeding, delayed wound healing) or major (hematoma or seroma requiring operation, infection requiring rehospitalization, blood product transfusion, total flap or nipple loss, implant removal), mixed (both minor and major complications), or multiple. Chi-square and multivariate logistic regressions were used for the analysis.

Results

Of the 600 patients, 391 (65 %) underwent UM and 209 (35 %) underwent CPM. Across all complication groups, there were significantly more complications in the CPM group versus the UM group (41.6 vs. 28.6 %, p = 0.001). Major complications alone were significantly greater in the CPM versus the UM group (13.9 vs. 4.1 %, p < 0.001). When adjusting for age, body mass index, smoking and diabetes history, AJCC stage, reconstruction, previous radiation therapy, and adjuvant therapy, CPM patients were 1.5 times more likely to have any complication (odds ratio [OR] 1.53; 95 % CI 1.04–2.25, p = 0.029) and 2.7 times more likely to have a major complication compared with UM patients (OR 2.66; 95 % CI 1.37–5.19, p = 0.004).

Conclusions

CPM patients have an increased risk of complications, especially major complications requiring rehospitalization or reoperation. These complications may influence patient and physician decisions to choose CPM.

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Acknowledgment

We would like to acknowledge the Auxiliary of Evanston and Glenbrook Hospitals at NorthShore University HealthSystem who provided generous support for this work.

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Authors and Affiliations

  1. Department of Surgery, The University of Chicago Medicine, Chicago, IL, USA

    Megan E. Miller MD, Catherine Pesce MD, Nora Jaskowiak MD, David J. Winchester MD & Katharine Yao MD

  2. Breast Surgical Program, Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA

    Tomasz Czechura MPH, Brigid Martz CCRP, Mary E. Hall BS, Catherine Pesce MD, David J. Winchester MD & Katharine Yao MD

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  1. Megan E. Miller MD
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Correspondence to Katharine Yao MD.

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Miller, M.E., Czechura, T., Martz, B. et al. Operative Risks Associated with Contralateral Prophylactic Mastectomy: A Single Institution Experience. Ann Surg Oncol 20, 4113–4120 (2013). https://doi.org/10.1245/s10434-013-3108-1

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  • DOI: https://doi.org/10.1245/s10434-013-3108-1

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