Surgical Outcomes of Ambulatory Mastectomy and Immediate Alloplastic Reconstruction for Breast Cancer or Risk...

There is a paucity of data on surgical outcomes after ambulatory mastectomy and immediate reconstruction. Our objective was to evaluate the feasibility and safety of ambulatory mastectomy with immediate alloplastic reconstruction.

We conducted a single institution retrospective cohort study of patients who underwent ambulatory mastectomy with immediate alloplastic reconstruction between 2015 and 2021. Demographic and clinical data were collected from medical chart review and summarized with descriptive statistics. A multivariable logistic regression model was used to determine the predictors of a surgical complication. P values < 0.05 were considered significant.

Three hundred forty women underwent ambulatory mastectomy with immediate reconstruction for breast cancer (169, 50%) or risk reduction (171, 50%). One hundred seventy five (51.5%) women underwent skin-sparing mastectomy and 165 (48.5%) underwent nipple-sparing mastectomy. Two hundred fifty seven (76%) had a subpectoral implant and 83 (24%) had a prepectoral implant. Forty eight (14%) of the patients developed a post-operative complication, 36 (11%) required a return to the operating room, and 15 (4%) had loss of their reconstruction. Only 21 patients (6%) required a hospital admission. In a multivariate logistic regression analysis, obesity was associated with significantly increased odds of developing a complication (OR 24.92, 95% CI 1.34-464.5, P = 0.03). However, other factors such as mastectomy type and device location did not affect complication rates.

Eighty six percent of the women undergoing pre-planned ambulatory mastectomy with immediate alloplastic reconstruction for risk reduction or breast cancer did not experience a post-operative complication. In our specific context, our experience suggests that mastectomy with immediate alloplastic reconstruction can be considered for same day discharge.