Reoperation for Complications after Lumpectomy and Mastectomy for Breast Cancer from the 2012 National Surgical Quality Improvement Program (ACS-NSQIP)

Abstract

Background: Hospital readmissions and reoperations are quality indicators of patient care. In 2012, the National Surgical Quality Improvement Program (ACS-NSQIP) began reporting details regarding unplanned reoperations within 30 days of initial procedure. The main objective of this study was to identify reoperation rates as a result of complications and evaluate complications by type of breast surgery.

Methods: Patients who underwent surgery for breast cancer were identified from the 2012 ACS-NSQIP Participant User File. Breast procedures were categorized as mastectomy or lumpectomy, each with or without immediate breast reconstruction (IBR). All reoperations and complication-related reoperations were categorized on the basis of procedure and diagnosis codes, and rates were compared by breast procedure by Chi square tests.

Results: Of 18,500 patients, 781 (4 %) required an unplanned reoperation within 30 days (single reoperation in 747, 2+ reoperations in 34). Mean time to first reoperation was 13.4 days and varied by procedure. A majority (73 %) of ACS-NSQIP coded unplanned reoperations were due to complications. Rates of reoperation due to complication were highest in mastectomy with IBR (7 %). Most common complications requiring reoperation were bleeding, followed by infection and wound-related problems.

Conclusions: Unplanned reoperations after breast cancer surgery are more frequent after mastectomy with IBR than other breast operations. Bleeding is the most common complication requiring reoperation.