Short-Term Outcomes Following Breast Cancer Surgery With and Without Neoadjuvant Chemotherapy: A Nationwide Administrative Database Study in Japan

Konishi, Takaaki; Fujiogi, Michimasa; Sato, Ayaka; Michihata, Nobuaki; Kumazawa, Ryosuke; Matsui, Hiroki; Fushimi, Kiyohide; Tanabe, Masahiko; Seto, Yasuyuki; Yasunaga, Hideo

doi:10.1245/s10434-021-11212-6

Cited by 9 publications

(6 citation statements)

References 33 publications

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“…First, further information regarding breast cancer, including cancer subtype and neoadjuvant therapy, was unavailable in the database. However, neoadjuvant therapy would not have affected postoperative bleeding concerning previous studies [18,44]. Moreover, because tumor characteristics were almost unrelated to postoperative bleeding in the current analysis, cancer subtype and histology would also have little effect on bleeding.…”

Section: Discussionmentioning

confidence: 77%

“…We chose Charlson and Elixhauser comorbidities as candidate comorbidities and their ICD‐10 codes were defined with reference to a previous study (details and corresponding ICD‐10 codes are shown in Supplementary Table 1 ) [16]. Similar to previous studies, we excluded breast cancer and axillary metastasis from the definition of comorbidities because they were the main disease [17, 18]. We defined heparin use as intravenous continuous administration and steroid use as oral and intravenous administration.…”

Section: Methodsmentioning

confidence: 99%

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Risk Factors for Postoperative Bleeding Following Breast Cancer Surgery: A Nationwide Database Study of 477,108 Cases in Japan

et al. 2022

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Background Although postoperative bleeding is a common and serious complication in breast cancer surgery, the risk factors remain unclear. Therefore, we examined the risk factors using a Japanese nationwide database. Methods Patients who underwent breast cancer surgery between July 2010 and March 2020 were identified from a Japanese nationwide database. Multivariable analyses for 47 candidate risk factors (4 patient characteristics, 32 comorbidities, 5 tumor characteristics, 3 preoperative drug uses, and 3 surgical procedures) were conducted to investigate risk factors associated with postoperative bleeding requiring reoperation. Two sensitivity analyses were conducted: an analysis for postoperative bleeding with or without reoperation and an analysis for patients who underwent total mastectomy without breast reconstruction. Results Among the 477,108 patients included, 7048 (1.5%) developed postoperative bleeding and 2357 (0.5%) underwent reoperation for postoperative bleeding. Male sex, old age, body mass index ≥ 25.0 kg/m2, several comorbidities (deficiency anemia, cardiac arrhythmias, hypertension, liver disease, psychoses, and valvular disease), preoperative heparin use, and several procedures were identified as risk factors. Deficiency anemia showed the highest odds ratio among the risk factors (4.41 [95% confidence interval, 3.63–5.36]). High odds ratios were also observed in total mastectomy (2.32 [2.10–2.56]), flap reconstruction (1.93 [1.55–2.40]), and preoperative heparin use (1.64 [1.26–2.14]). The results corresponded with the sensitivity analyses. Conclusions This study identified several risk factors for postoperative bleeding in breast cancer surgery, such as high body mass index, anemia, cardiovascular diseases, liver diseases, psychoses, preoperative heparin use, and surgical procedures.

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Section: Discussionmentioning

confidence: 77%

Section: Methodsmentioning

confidence: 99%

Risk Factors for Postoperative Bleeding Following Breast Cancer Surgery: A Nationwide Database Study of 477,108 Cases in Japan

et al. 2022

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“…In previous studies 38–41 , the proportion of patients with breast cancer receiving neoadjuvant therapy varied from 4.7 to 8.9%. This is likely explained by differences in the study intervals and type of surgery.…”

Section: Discussionmentioning

confidence: 97%

Impact of type 2 diabetes on complications after primary breast cancer surgery: Danish population-based cohort study

Kjærgaard,

Wheler,

Dihge

et al. 2024

British Journal of Surgery

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Background Knowledge is sparse on the impact of type 2 diabetes (T2D) on surgical outcomes after breast cancer surgery. This study investigated the association between T2D and risk of complications after primary breast cancer surgery, and evaluated the biological interaction between T2D and co-morbidities. Methods Using the Danish Breast Cancer Group clinical database, a cohort of all Danish women diagnosed with early-stage breast cancer during 1996–2022 was created. All patients underwent mastectomy or breast-conserving surgery. Information on prevalent T2D was collected from Danish medical and prescription registries. Surgical complications were defined as hospital diagnoses for medical or surgical complications developing within 30 days after primary breast cancer surgery. The 30-day cumulative incidence proportion of complications was calculated, and Cox regression was used to estimate HRs. Interaction contrasts were computed to determine the additive interaction between T2D and co-morbidities on the incidence rate of complications. Results Among 98 589 women with breast cancer, 6332 (6.4%) had T2D at breast cancer surgery. Overall, 1038 (16.4%) and 9861 (10.7%) women with and without T2D developed surgical complications, yielding cumulative incidence proportions of 16 (95% c.i. 15 to 17) and 11 (10 to 11)% respectively, and a HR of 1.43 (95% c.i. 1.34 to 1.53). The incidence rate of surgical complications explained by the interaction of T2D with moderate and severe co-morbidity was 21 and 42%, respectively. Conclusion Women with breast cancer and T2D had a higher risk of complications after primary breast cancer surgery than those without T2D. A synergistic effect of T2D and co-morbidity on surgical complications can explain this association.

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“…BC treatment modalities include breast surgery, radiotherapy and systemic therapies (endocrine therapy, chemotherapy, targeted therapy, and immunotherapy) [9,10]. The decision on systemic treatment is based on several clinicopathological features such as ER, PR, and HER-2 status as well as the stage of cancer, tumor size, nodal involvement, menopausal status, age and health status of the patient [7].…”

Section: Introductionmentioning

confidence: 99%

Impact of anticancer therapy on the quality of life of Sudanese patients with breast cancer at Khartoum oncology hospital

Aldaak

Suliman

Abd-Elgadir³

et al. 2022

BMC Women's Health

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Background Chemotherapy-related toxicity affects the quality of life (QOL) of patients with cancer. Measuring the QOL in breast cancer (BC) patients has been the focus of clinical practices and research in recent decades. This study aimed to assess the impact of BC medications on QOL of Sudanese patients with BC. Methods A cross-sectional study was conducted in Khartoum Oncology Hospital, Sudan, from November 2020 to March 2021. All patients diagnosed with BC were included in the study. QOL was assessed using the European Organization for Research and Treatment of Cancer quality of life (EORTC QLQ-C-30) and breast cancer supplementary module (QLQ-BR23). ANOVA, independent t-test and logistic regression analysis were used to assess the association between variables. Results Two hundred patients were enrolled in the study, with a mean age of 50 ± 11.7 years. 52.5% of the patients were on a conventional therapy whereas 40.5% and 7% received hormonal and HER2-targeted therapies, respectively. In QLQ-C30 scale, the global health-QOL status score was (53.2 ± 1.9), with 54.0% of patients having poor global health-QOL status. In the functional scale, the cognitive functioning was the highest score (80.7 ± 1.8). In QLQ-C30 symptom scale, the most distressing issue was financial difficulties (63.7 ± 2.9). In QLQ-BR23 scale, body image scored the worse functioning (47.7 ± 2.7), with 54.5% of patients having poor QOL. In QLQ-BR23 symptoms scale, “being upset by hair loss” was the highest disturbing symptom (62.1 ± 3.3), with 68.6% of patients having poor QOL. Global health status (P = 0.000), social (P = 0.000), emotional (P = 0.002) and role functioning (P = 0.000) were significantly higher in patients taking HER2-targeted or hormonal therapy compared to conventional therapy. The level of symptomatology was significantly low in patients taking HER2-targeted therapy or hormonal therapy (P = 0.000) than those on conventional therapy. Hormonal (OR = 3.7, p = 0.01) and HER2-targeted therapies (OR = 10.2, p = 0.04 ) were positive predictors of QOL. Conclusion BC survivors in Sudan had a low QOL/global health status. Hormonal and HER2-targeted therapies were predictors of good QOL.

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Short-Term Outcomes Following Breast Cancer Surgery With and Without Neoadjuvant Chemotherapy: A Nationwide Administrative Database Study in Japan

Cited by 9 publications

References 33 publications

Risk Factors for Postoperative Bleeding Following Breast Cancer Surgery: A Nationwide Database Study of 477,108 Cases in Japan

Risk Factors for Postoperative Bleeding Following Breast Cancer Surgery: A Nationwide Database Study of 477,108 Cases in Japan

Impact of type 2 diabetes on complications after primary breast cancer surgery: Danish population-based cohort study

Impact of anticancer therapy on the quality of life of Sudanese patients with breast cancer at Khartoum oncology hospital

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