Feasibility and safety of outpatient breast cancer surgery

Improvement in perioperative care programmes has facilitated post-operative recovery and use of short-term or outpatient procedures. The aim of this study was to assess the feasibility and safety of an outpatient breast cancer programme in patients referred to a large breast cancer unit.

After an introduction period involving 554 consecutive patients, all patients operated from 1 November 2015 to 30 June 2016 (a total 483 patients) were treated with multimodal oral analgesia, preoperative high-dose glucocorticoids and no routine use of drains. Planned inpatient surgery included patients with mastectomy > 70 years, < 8 h in post-operative observation and < 2 h of observation after mobilisation.

Of the 382 patients who were planned for outpatient surgery (79%), 90% received surgery in an outpatient setup. Among the 101 patients (21%) who were planned for inpatient surgery, 17% returned home on the day of surgery. Consequently, the overall outpatient rate was 72% and the overall mean length of stay was 0.3 days, ranging from 0.1 days for breast-conserving surgery to 0.8 days for mastectomy. About 2% were readmitted within < 30 days, mostly due to wound problems.
Conclusion: Outpatient breast cancer surgery is feasible and safe in most patients in a socialised healthcare system.

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