title: Operative risks associated with contralateral prophylactic mastectomy: a single institution experience.
abstract: BACKGROUND
  The purpose of this study was to determine if newly diagnosed breast cancer patients undergoing contralateral prophylactic mastectomy (CPM) experience more complications than patients undergoing unilateral mastectomy (UM).
  
  
  METHODS
  A total of 600 patients underwent either UM or CPM between January 2009 and March 2012 for unilateral breast cancer. Operative complications were classified as minor (aspirations, infection requiring antibiotics, partial flap and nipple necrosis, minor bleeding, delayed wound healing) or major (hematoma or seroma requiring operation, infection requiring rehospitalization, blood product transfusion, total flap or nipple loss, implant removal), mixed (both minor and major complications), or multiple. Chi-square and multivariate logistic regressions were used for the analysis.
  
  
  RESULTS
  Of the 600 patients, 391 (65 %) underwent UM and 209 (35 %) underwent CPM. Across all complication groups, there were significantly more complications in the CPM group versus the UM group (41.6 vs. 28.6 %, p = 0.001). Major complications alone were significantly greater in the CPM versus the UM group (13.9 vs. 4.1 %, p < 0.001). When adjusting for age, body mass index, smoking and diabetes history, AJCC stage, reconstruction, previous radiation therapy, and adjuvant therapy, CPM patients were 1.5 times more likely to have any complication (odds ratio [OR] 1.53; 95 % CI 1.04-2.25, p = 0.029) and 2.7 times more likely to have a major complication compared with UM patients (OR 2.66; 95 % CI 1.37-5.19, p = 0.004).
  
  
  CONCLUSIONS
  CPM patients have an increased risk of complications, especially major complications requiring rehospitalization or reoperation. These complications may influence patient and physician decisions to choose CPM.
authors.affiliation: Department of Surgery, The University of Chicago Medicine, Chicago, IL, USA, megan.miller2@uchospitals.edu.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Miller
authors.forename: Tomasz
authors.initials: T
authors.lastname: Czechura
authors.forename: Brigid
authors.initials: B
authors.lastname: Martz
authors.forename: Mary E
authors.initials: ME
authors.lastname: Hall
authors.forename: Catherine
authors.initials: C
authors.lastname: Pesce
authors.forename: Nora
authors.initials: N
authors.lastname: Jaskowiak
authors.forename: David J
authors.initials: DJ
authors.lastname: Winchester
authors.forename: Katharine
authors.initials: K
authors.lastname: Yao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult