Value of Ambulatory Modified Radical Mastectomy

Area of Science:

• Oncology
• Surgical Oncology
• Health Economics

Background:

• Modified radical mastectomy (MRM) is predominantly performed in inpatient settings.
• The value of ambulatory MRM, considering expenditures and complications, requires evaluation.

Purpose of the Study:

• To determine the safety and cost-effectiveness of ambulatory modified radical mastectomy (MRM).
• To compare readmission rates and healthcare charges between inpatient and ambulatory MRM.

Main Methods:

• Utilized Health Care Utilization Project (HCUP) state databases from 2016 for MRM patient data.
• Examined 30-day readmission rates for surgical-site infection (SSI) or hematoma.
• Analyzed healthcare charges by index care setting and identified predictors of readmission.

Main Results:

• Ambulatory MRM (37%) had lower readmission rates (1.7%) compared to inpatient MRM (2.5%).
• Ambulatory MRM incurred significantly lower adjusted charges ($94,463 vs. $113,878 without readmission).
• The ambulatory setting was protective against readmission (OR, 0.49; p < 0.01).

Conclusions:

• Ambulatory MRM is a safe and less expensive alternative to inpatient care.
• Findings support the transition of MRM to the ambulatory setting for appropriate patients.
• This shift can optimize resource utilization in breast surgical oncology.