Major surgical postoperative complications and survival in breast cancer: Swedish population-based register study in 57 152 women

This study aimed to determine potential association between postoperative complications and survival in breast cancer patients as postoperative complications may activate prometastatic pathways. Patient cohort included 57152 patients who underwent breast cancer surgery (2008-2017). Only major surgical complications requiring re-operation or re-admission within 30 days were considered. Such complications occurred in 1854 patients (3.2%). Overall, 3472 patients (6.1%) died from breast cancer at median follow up of 6.2 years. Major surgical complications were more common after mastectomy with or without immediate breast reconstruction (7.3% and 4.3% respectively) when compared to breast conserving surgery (2.3%). Unadjusted 5 year overall survival (OS) and breast cancer specific survival (BCSS) were 82.6% and 92.1% respectively for patients with major surgical complications, and 88.8% and 95% for patients without such complications. After adjusting for potential confounders, all-cause and breast cancer mortality rates remained higher after major surgical complications (OS: HR 1.32 / BCSS: HR 1.31). After stratification for type of breast surgery, this association remained significant only for patients receiving mastectomy without reconstruction (OS: HR 1.41 / BCSS: HR 1.36).

Classifications: Breast & Oncoplastic Surgery

Keywords: Breast Surgery Complications Trials