title: Cardiac Surgery is Safe in Female Patients with a History of Breast Cancer.
abstract: OBJECTIVE
  In cardiac surgery candidates, a concomitant history of breast cancer suggests adverse outcomes. The possibility of internal mammary artery (IMA) utilization and its patency rate is frequently discussed. Secondary, blood loss and wound related infections might be important issues. However, publications focusing on these issues are limited.
  
  
  METHODS
  We analyzed 32 patients with previously treated breast cancer undergoing cardiac bypass (CABG) and combined CABG surgery matched to 99 control subjects in a retrospective cohort study. Patients were analyzed regarding IMA utilization, blood loss and substitution and frequent perioperative complications as well as long-term mortality.
  
  
  RESULTS
  No significant differences between groups were observed regarding duration of surgery, IMA-utilization, incidence of infections and postoperative complications or mortality. A pronounced decline of hemoglobin/hematocrit was evident within the first 6 postoperative hours (3.3 ± 1.8 vs. 2.5 ± 1.8 mg/dl; p = 0.03) in breast cancer patients not related to an increased drainage loss but associated with an increase of international normalized ratio (INR) (0.39 ± 0.16 vs. 0.29 ± 0.24; p <0.01).
  
  
  CONCLUSIONS
  In breast cancer patients, CABG and combined CABG procedures can safely be performed with comparable short- and long-term results.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University Hospital, Würzburg, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Leistner
authors.forename: Stefanie
authors.initials: S
authors.lastname: Sommer
authors.forename: Ivan
authors.initials: I
authors.lastname: Aleksić
authors.forename: Christoph
authors.initials: C
authors.lastname: Schimmer
authors.forename: Elisa
authors.initials: E
authors.lastname: Schmidt-Hengst
authors.forename: Rainer G
authors.initials: RG
authors.lastname: Leyh
authors.forename: Sebastian-Patrick
authors.initials: SP
authors.lastname: Sommer
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D018579:Patient Selection; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome