Concurrent risk-reduction surgery in patients with increased lifetime risk for breast and ovarian cancer: an analysis of the National Surgical Quality Improvement Program (NSQIP) database

Background Patients with genetic susceptibility to breast and ovarian cancer are eligible for risk-reduction surgery. Surgical morbidity of risk-reduction mastectomy (RRM) with concurrent bilateral salpingo-oophorectomy (BSO) is unknown. Outcomes in these patients were compared to patients undergoin...

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Bibliographic Details
Published in:Breast cancer research and treatment 2018-08, Vol.171 (1), p.217-223
Main Authors: Elmi, Maryam, Azin, Arash, Elnahas, Ahmad, McCready, David R., Cil, Tulin D.
Format: Article
Language:English
Subjects:
Adult
Biopsy
Body mass index
Breast
Breast cancer
Breast Neoplasms - diagnosis
Breast Neoplasms - epidemiology
Breast Neoplasms - prevention & control
Breast Neoplasms - surgery
Breast reconstruction
Cancer research
Comparative analysis
Databases, Factual
Disease susceptibility
Epidemiology
Female
Health aspects
Health risk assessment
Humans
Mastectomy
Medicine
Medicine & Public Health
Middle Aged
Morbidity
Multivariate analysis
Oncology
Ovarian cancer
Ovarian Neoplasms - diagnosis
Ovarian Neoplasms - epidemiology
Ovarian Neoplasms - prevention & control
Ovarian Neoplasms - surgery
Ovariectomy
Premedication - methods
Public Health Surveillance
Quality control
Quality improvement
Quality management
Retrospective Studies
Salpingo-oophorectomy
Smoking
Surgery
Surgical site infections
Thromboembolism
United States
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Summary:Background Patients with genetic susceptibility to breast and ovarian cancer are eligible for risk-reduction surgery. Surgical morbidity of risk-reduction mastectomy (RRM) with concurrent bilateral salpingo-oophorectomy (BSO) is unknown. Outcomes in these patients were compared to patients undergoing RRM without BSO using a large multi-institutional database. Methods A retrospective cohort analysis was conducted using the American College of Surgeon’s National Surgical Quality Improvement Program (NSQIP) 2007–2016 datasets, comparing postoperative morbidity between patients undergoing RRM with patients undergoing RRM with concurrent BSO. Patients with genetic susceptibility to breast/ovarian cancer undergoing risk-reduction surgery were identified. The primary outcome was 30-day postoperative major morbidity. Secondary outcomes included surgical site infections, reoperations, readmissions, length of stay, and venous thromboembolic events. A multivariate analysis was performed to determine predictors of postoperative morbidity and the adjusted effect of concurrent BSO on morbidity. Results Of the 5470 patients undergoing RRM, 149 (2.7%) underwent concurrent BSO. The overall rate of major morbidity and postoperative infections was 4.5% and 4.6%, respectively. There was no significant difference in the rate of postoperative major morbidity (4.5% vs 4.7%, p  = 0.91) or any of the secondary outcomes between patients undergoing RRM without BSO vs. those undergoing RRM with concurrent BSO. Multivariable analysis showed Body Mass Index (OR 1.05; p  
ISSN:0167-6806
1573-7217
DOI:10.1007/s10549-018-4818-7