Surgical outcomes of concurrent prophylactic mastectomy and oophorectomy compared to mastectomy and hysterectomy, in hereditary breast and gynecologic cancer: A NSQUIP database analysis

• Published in: Journal of obstetrics and gynaecology Canada Vol. 42; no. 5; p. 679
• Main Authors: Le, Ai-Lien, Liao, Yan, Xie, Rihua, Chen, Innie
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.05.2020
• Subjects: mastectomy; oophorectomy; prophylactic surgery; surgical outcomes; mastectomy; oophorectomy; surgical outcomes; prophylactic surgery
• ISSN: 1701-2163
• DOI: 10.1016/j.jogc.2020.02.057

To assess the surgical outcomes of concurrent prophylactic mastectomy and oophorectomy compared to prophylactic mastectomy and hysterectomy, in hereditary breast and gynecologic cancer. An analysis of perioperative outcomes using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was conducted. Patients with a genetic susceptibility to malignant breast and ovarian neoplasms were identified using ICD codes. Patients having mastectomy, oophorectomy, and hysterectomy were identified using Current Procedural Terminology codes. Individuals that had a mastectomy and oophorectomy were compared with those that had a mastectomy and hysterectomy, with respect to postoperative outcomes. Chi square tests and t tests were used to test for significant differences. Of 4673 women undergoing prophylactic mastectomy in our dataset, 82 (1.75%) underwent concurrent mastectomy and oophorectomy, while 46 (0.98%) underwent concurrent mastectomy and hysterectomy. No significant differences in age (mean±SD 46.37±9.00 vs. 44.00±8.66 years), normal BMI (45.12% vs. 45.65%), non-smoking status (82.93% vs. 89.13%), non-diabetes status (96.34% vs. 100%), classified ASA I (17.07% vs. 26.09%), and pre-operative hematocrit (38.39±3.51 vs. 37.05±6.69) were observed. For concurrent mastectomy and hysterectomy cases, they were more likely to be inpatient surgery (86.96% vs. 69.51%) (p<0.05) compared to concurrent mastectomy and oophorectomy. However, there were no significant differences in the rates of surgical site infections, sepsis, wound disruptions, intraoperative and postoperative transfusions, and re-operations. The surgical outcomes are similar when comparing concurrent mastectomy and oophorectomy to mastectomy and hysterectomy. The NSQIP data suggests either strategy performed does not increase surgical and medical complications perioperatively.