Prospective Evaluation of Complications and Associated Risk Factors in Breast Cancer Surgery

Abstract

Background. Surgical site infection (SSI) is a well-known complication after breast cancer surgery. The primary aim was to assess risk factors for SSI. Risk factors for other wound complications were also studied. Materials and Methods. In this prospectively registered cohort study, patients who underwent breast-conserving surgery (BCS) or mastectomy between May 2017 and May 2019 were included. Data included patient and treatment characteristics, infection, and wound complication rates. Risk factors for SSI and wound complications were analyzed with simple and multiple logistic regression. Results. The study cohort consisted of 592 patients who underwent 707 procedures. There were 66 (9.3%) SSI and 95 (13.4%) wound complications. “ BMI > 25 ,” “oncoplastic BCS,” “reoperation within 24 hour,” and “prolonged operative time” were risk factors for SSI with simple analysis. BMI 25-30 and >30 remained as significant risk factors for SSI with adjusted analysis. Risk factors for “any wound complication” with adjusted analysis were “mastectomy with/without reconstruction” in addition to “BMI 25-30” and “ BMI > 30 .” Conclusion. The only significant risk factor for SSI on multivariable analysis were BMI 25-30 and BMI > 30 . Significant risk factors for “any wound complication” on multivariable analysis were “mastectomy with/without reconstruction” as well as “BMI 25-30” and “ BMI > 30 .”

Comprehensive analysis of risk factors for postoperative wound infection following radical mastectomy in breast cancer patients

“…The multifaceted aetiology of these infections underscores the necessity for a comprehensive analysis of their risk factors 10,11 . Radical mastectomy, while being a cornerstone in the management of breast cancer, inherently involves extensive tissue dissection and lymph node clearance, which can compromise local immunity and disrupt the integrity of tissue barriers, making the surgical site susceptible to microbial invasion 12 . Our study's exploration into the myriad of factors contributing to PWIs provides valuable insights into the interplay between patient‐specific variables and procedural variables.…”

“…10,11 Radical mastectomy, while being a cornerstone in the management of breast cancer, inherently involves extensive tissue dissection and lymph node clearance, which can compromise local immunity and disrupt the integrity of tissue barriers, making the surgical site susceptible to microbial invasion. 12 Our study's exploration into the myriad of factors contributing to PWIs provides valuable insights into the interplay between patient-specific variables and procedural variables. For instance, systemic factors such as immunosuppression, either from chemotherapy or the malignancy itself, and local factors like impaired blood supply due to extensive surgical resection, each play a pivotal role in the risk profile for PWIs.…”