Surgeries can be stressful and difficult for patients, and it’s understandable that some would want to reduce the number of days they need to devote to surgical procedures. This desire has led some women to choose to combine breast and gynecologic procedures, such as cancer-preventive breast surgeries, hysterectomy and/or ovarian removal, into a single hospital visit. But, a new study out of the University of Colorado (CU) Cancer Center recently published in Breast Journal advises against this practice. This recommendation is based on an analysis of data from the National Surgery Quality Improvement Program (NSQIP) database.
The researchers involved found several negative trends associated with doubling up on these surgeries, including higher complication, readmission, and reoperation rates, a much longer length of stay at the hospital (compared to patients who had a single site surgery). These findings were drawn from the records of 77,030 women who had breast surgery between 2011 and 2015, 124 of whom also had a gynecologic surgery at the same time. Usually, younger women made this choice, but this group still showed the higher rate of surgery complications.
“In patients at high risk of developing breast cancer and ovarian cancer, we recommend doing the prophylactic bilateral mastectomy along with breast reconstruction, but then trying to keep gynecologic surgery separate. It's safer and easier to do them separately," Dr. Sarah Tevis, CU Cancer Center investigator and breast surgeon at UC Health University of Colorado Hospital, told EurekAlert.
Treatment delays tied to scheduling difficulties are also sometimes associated with combining surgical procedures. And, complications can delay the start of chemo for some patients, which has further ramifications.
Tevis points out that, for some patients, a medical condition may make combining surgeries and only undergoing anesthesia once preferable. But she describes these cases as “rare.” Further research on these topics will attempt to identify which women will have better or worse reactions to the various surgical scheduling approaches.