title: Early postoperative outcomes in lumpectomy versus simple mastectomy.
abstract: BACKGROUND
  Relatively scarce outcomes research exists that compares early postoperative complications between breast conservation surgery (BCS) and simple mastectomy (SM). Such information would improve a surgeon's ability to provide informed consent when considering treatment options, especially for women with early stage breast cancer who have the option to receive either BCS or SM.
  
  
  METHODS
  The National Surgical Quality Improvement Program database from years 2009-2012 was analyzed. For each treatment group, we used Current Procedural Terminology codes specific to the treatment modality with sentinel lymph node biopsy as an inclusion criteria. We excluded patients who received axillary lymphadenectomies, bilateral disease or symmetry procedures, and additional breast reconstructive surgery. We compared each group with chi square and two-sample t-tests to look for preoperative comorbidity differences, then used unadjusted odds ratios to compare postoperative complication rates.
  
  
  RESULTS
  Inclusion and exclusion criteria provided 6682 patients in the BCS group and 3339 patients in the SM group. Baseline comorbid condition characteristics showed no clinical differences between groups except for diabetes (8.5% in SM versus 6.5% in BCS). Statistical analysis between each treatment modality revealed that the SM group had significantly higher wound complications, bleeding, infections, and overall complications than the BCS group.
  
  
  CONCLUSIONS
  Although both BCS and SM options have low early postoperative complication rates when treating early stage breast cancer, BCS has fewer complications with regard to bleeding, wound complications and infections.
authors.affiliation: Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Chatterjee
authors.affiliation: Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. Electronic address: Bryan.j.pyfer.MED@dartmouth.edu.
authors.forename: Bryan
authors.initials: B
authors.lastname: Pyfer
authors.affiliation: Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
authors.forename: Brian
authors.initials: B
authors.lastname: Czerniecki
authors.affiliation: Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
authors.forename: Kari
authors.initials: K
authors.lastname: Rosenkranz
authors.affiliation: Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
authors.forename: Julia
authors.initials: J
authors.lastname: Tchou
authors.affiliation: Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
authors.forename: Carla
authors.initials: C
authors.lastname: Fisher
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000009:adverse effects*; D015413:Mastectomy, Simple / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*
keywords: Complications; Lumpectomy; NSQIP; Outcomes; Postoperative; Simple mastectomy