Surgical treatment of breast lesions at a Day Centre: Experience of the European Institute of Oncology

Ballardini, B.; Cavalli, Marta; Manfredi, Gianfranco; Sangalli, Claudia; Galimberti, Viviana; Intra, Mattia; Rossi, Elisabetta; Seco, Javiera; Campanelli, G.; Veronesi, Giulia

doi:10.1016/j.breast.2016.04.002

Cited by 8 publications

(16 citation statements)

References 33 publications

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“…Nevertheless, SDS was progressively utilized in North America in the 1990s 6,9 . In Europe, mastectomy has been considered more burdensome for the patient, and it has, therefore, been more frequently performed as an inpatient procedure, whereas BCS has been performed with an outpatient regime 10–12 . Later research has shown increasing evidence of safety of the SDS with higher psychological satisfaction when compared to inpatient mastectomy 13–17 .…”

Section: Introductionmentioning

confidence: 99%

Same‐day mastectomy and axillary lymph node dissection is safe for most patients with breast cancer

Tamminen

Meretoja

Koskivuo

2022

Journal of Surgical Oncology

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Background and Objective The aim of this study was to evaluate the safety of same‐day mastectomy, with or without a sentinel node biopsy (SNB) and/or axillary lymph node dissection (ALND). Methods In this retrospective study, we reviewed 913 consecutive women who underwent a simple mastectomy for breast cancer between the years 2014 and 2019 and were treated either with same‐day surgery (SDS) or an overnight stay (OS) regime. We reviewed all surgical complications, any unplanned return to care (RTC) and the rehospitalization rate for 30 postoperative days. Results A total of 259 patients (28%) were treated with SDS and 654 patients (72%) with an OS regime. There was no difference in RTC (odds ratio: 0.79 [95% confidence interval: 0.53–1.18], p = 0.26) or any major complications between the groups. None of the investigated subgroups, such as patients with previous neoadjuvant therapy, diabetes, obesity (up to a body mass index of 40 kg/m2), the American Society of Anaesthesiologist Class of 3, or elderly patients aged 75–84 years, showed an increased complication rate when treated with the SDS regime. Conclusion A same‐day simple mastectomy is safe with SNB and/or ALND. It can be performed safely for most patients with stable co‐morbidities.

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Section: Introductionmentioning

confidence: 99%

Same‐day mastectomy and axillary lymph node dissection is safe for most patients with breast cancer

Tamminen

Meretoja

Koskivuo

2022

Journal of Surgical Oncology

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“…Even though all patients received two standard prophylactic anti‐emetics, and only 3.3% received volatile anaesthesia, 17.8% experienced nausea and 1.2% vomited after returning home. In contrast, Ballardini et al 5 reported only 1.5% nausea, but among the patients converted to inpatients in their study, 22% were admitted because of persistent nausea/vomiting. Wesmiller et al 14 on the other hand, recently reported 35% nausea and 8.2% vomiting up to 48h after BC surgery, when using a multimodal prophylaxis.…”

Section: Discussionmentioning

confidence: 66%

“…Pain intensity is usually at its highest on the day after surgery 22 but only 5.3% of our patients reported moderate‐to‐severe pain at rest on POD1. In a similar study population, Ballardini et al 5 found an incidence of 6.7% moderate‐to‐severe pain, also with the use of multimodal analgesic techniques. In contrast, Susini et al 6 recently reported 40.6% postdischarge pain of NRS 4 or higher after ambulatory BC surgical procedures comparable to ours, but with a less extensive pain prophylaxis.…”

Section: Discussionmentioning

confidence: 81%

“…Ambulatory BC surgery has been practiced at Oslo University Hospital (OUH), Norway, since 1997 and today approximately 60% of these patients are discharged the same day. Even though ambulatory surgery for BC is regarded as safe, 2,3 overnight stay is still predominant in many countries 4–6 …”

Section: Introductionmentioning

confidence: 99%

“…Even though ambulatory surgery for BC is regarded as safe, 2,3 overnight stay is still predominant in many countries. [4][5][6] Only a few hours after surgery, day-surgical patients are discharged home, which means that most of the recovery process takes place out of hospital and professional facilities. Common postdischarge symptoms associated with ambulatory surgery are pain, nausea and vomiting, [7][8][9][10] which implies discomfort and may prolong the time to mobilization and resumption of normal daily activities.…”

Section: Introductionmentioning

confidence: 99%

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Postdischarge pain, nausea and patient satisfaction after diagnostic and breast‐conserving ambulatory surgery for breast cancer: A cross‐sectional study

Stjernberg

Schlichting

Rustøen

et al. 2021

Acta Anaesthesiol Scand

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Background The aims of this study were to assess first day postdischarge pain, nausea and patient satisfaction in ambulatory breast cancer surgical patients, after diagnostic and breast conserving procedures. Methods A total of 781 women, aged 18–85 years were included in this prospective, cross‐sectional study. All patients received standardized multimodal pain prophylaxis with paracetamol, COX‐II inhibitor, dexamethasone and wound infiltration with local anaesthetics. Nausea prophylaxis was provided with ondansetron. Most patients received general anaesthesia with propofol and remifentanil. Data were collected using a validated questionnaire during telephone follow‐up on the first postoperative day. Results The response rate was 94.5%. NRS ≥ 4 was reported by 5.3% at rest, by 17% during activity and by 30.7% as the worst pain score. Young age was strongly associated with more pain both at rest, during activity and regarding worst pain since discharge. Postdischarge nausea was present in 17.8%, and vomiting in 1.2%. High pain score during activity and higher level of worst pain, were associated with nausea. There was no association between nausea and age, type of anaesthesia, surgical procedure or pain at rest. Patient satisfaction was high (97.8%–99.7%) regarding information, time for discharge and overall satisfaction. Conclusion Pain scores and incidence of nausea were generally low on the day after surgery. Young age was a strong predictor for postdischarge pain. A high worst pain score and high pain score during the activity were associated with postdischarge nausea. Patient satisfaction was high.

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Facteurs limitant la prise en charge ambulatoire en chirurgie mammaire

et al. 2019

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Surgical treatment of breast lesions at a Day Centre: Experience of the European Institute of Oncology

Cited by 8 publications

References 33 publications

Same‐day mastectomy and axillary lymph node dissection is safe for most patients with breast cancer

Same‐day mastectomy and axillary lymph node dissection is safe for most patients with breast cancer

Postdischarge pain, nausea and patient satisfaction after diagnostic and breast‐conserving ambulatory surgery for breast cancer: A cross‐sectional study

Facteurs limitant la prise en charge ambulatoire en chirurgie mammaire

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