title: Randomised controlled trial of effects of early discharge after surgery for breast cancer.
abstract: OBJECTIVE
  To determine the effect of early discharge from hospital after surgery for breast cancer on physical and psychological illness.
  
  
  METHODS
  Randomised controlled trial comparing discharge two days after surgery (before removal of drain) with standard management (discharge after removal of drain).
  
  
  METHODS
  Regional breast unit.
  
  
  METHODS
  100 women with early breast cancer undergoing mastectomy and axillary node clearance (20) or breast conservation surgery (80).
  
  
  METHODS
  Physical illness (infection, seroma formation, shoulder movement) and psychological illness (checklist of concerns, Rotterdam symptom questionnaire, hospital anxiety and depression scale) preoperatively and at one month and three months postoperatively.
  
  
  RESULTS
  Women discharged early had greater shoulder movement (odds ratio 0.28 (95% confidence interval 0.08 to 0.95); P = 0.042) and less wound pain (odds ratio 0.28 (0.10 to 0.79); P = 0.016) three months after surgery compared with women given standard management. One month after surgery scores were significantly lower on the Rotterdam symptom questionnaire in patients who were discharged early (ratio of geometric mean scores 0.73 (0.55 to 0.98) P = 0.035), but rates of psychological illness generally did not differ between groups.
  
  
  CONCLUSIONS
  Increased rates of physical or psychological illness did not result from early discharge after surgery for breast cancer. This policy can be recommended for patients with support at home.
authors.affiliation: Department of Surgery, Christie Hospital NHS Trust, Manchester M20 4BX. bundredn@fs1.with.man.ac.uk
authors.forename: N
authors.initials: N
authors.lastname: Bundred
authors.forename: P
authors.initials: P
authors.lastname: Maguire
authors.forename: J
authors.initials: J
authors.lastname: Reynolds
authors.forename: J
authors.initials: J
authors.lastname: Grimshaw
authors.forename: J
authors.initials: J
authors.lastname: Morris
authors.forename: L
authors.initials: L
authors.lastname: Thomson
authors.forename: L
authors.initials: L
authors.lastname: Barr
authors.forename: A
authors.initials: A
authors.lastname: Baildam
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D003863:Depression / Q000209:etiology; D004322:Drainage; D004487:Edema / Q000209:etiology; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology; D007902:Length of Stay; D008197:Lymph Node Excision; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000209:etiology; D011379:Prognosis; D012785:Shoulder Joint