Predictors of re-operation due to post-surgical bleeding in breast cancer patients: A Danish population-based cohort study

• Published in: European journal of surgical oncology Vol. 38; no. 5; pp. 407 - 412
• Main Authors: Winther Lietzen, L., Cronin-Fenton, D., Garne, J.P., Kroman, N., Silliman, R., Lash, T.L.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.05.2012
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Aging; Breast neoplasms; Breast Neoplasms - surgery; Cohort Studies; Denmark; Denmark - epidemiology; Epidemiology; Female; Glucocorticoid; Glucocorticoids - administration & dosage; Glucocorticoids - adverse effects; Hematology, Oncology and Palliative Medicine; Humans; Mastectomy, Modified Radical - adverse effects; Mastectomy, Segmental - adverse effects; Middle Aged; Odds Ratio; Post-surgical bleeding; Postoperative Hemorrhage - epidemiology; Postoperative Hemorrhage - etiology; Postoperative Hemorrhage - surgery; Predictive Value of Tests; Reoperation - statistics & numerical data; Risk Assessment; Risk Factors; Surgery; Denmark; Aging; Denmark; Breast neoplasms; Epidemiology; Glucocorticoid; Post-surgical bleeding
• ISSN: 0748-7983; 1532-2157; 1532-2157
• DOI: 10.1016/j.ejso.2012.02.184

To assess the risk of re-operation due to post-surgical bleeding after initial breast cancer surgery and to identify predictors of re-operation. We conducted a population-based study in Denmark. Patients were categorized according to age group, surgery type, and glucocorticoid use before surgery: never, current (0–90 days), and former (>90 days). We calculated the risk of re-operation due to post-surgical bleeding within 14 days after surgery, risk differences, and risk ratios of re-operation associated with age group, surgery type, and glucocorticoid use. 19,919 women were studied; 508 were re-operated. 3573 of the 19,919 women ever used glucocorticoids. Older age and mastectomy increased the risk of post-surgical bleeding compared with breast conserving surgery and younger age among both ever and never users of glucocorticoids. The crude risk of re-operation was 2.5% among never users of glucocorticoids, 2.6% among ever users and 4.0% among current users. Women aged ≥80 who were ever users of glucocorticoids and who had a mastectomy had 8.1% risk of re-operation due to post-surgical bleeding, whereas women <80 years old who never used glucocorticoids and who had breast conserving surgery had a 1.7% risk of re-operation. Older age, mastectomy, and – in some women – glucocorticoid use add an extra risk of re-operation due to bleeding. Clinicians and their patients can use this information to evaluate the patient-specific risk of this complication.