Application of radical mastectomy in ambulatory surgery centres under COVID-19

Background: Breast cancer has surpassed lung cancer as the most common cancer. Day surgery for breast cancer has been widely carried out worldwide, but the development of day surgery in China is relatively slow. To reduce the spread of coronavirus 2019 (COVID-19), major surgery centres have optimized the management procedures of day surgery to different degrees. However, relevant research on whether the rapid turnover of day surgery and the excessive human resources placed in the prevention and control of the COVID-19 epidemic will affect the quality of day surgery is lacking. Method The demographic data, clinical data and postoperative complications of breast cancer patients in the single medical group of West China Hospital of Sichuan University from March 2020 to June 2021 were retrospectively collected, and the complications after discharge and the safety of day surgery were analysed. Results The average age significantly differed between the ward surgery group (WS) and the day surgery group (DS) (P = 0.030). Regarding postoperative complications, no significant differences were detected in total surgical complications (P = 0.676) or anaesthesia complications (P = 0.126) between the two groups. In the logistic analysis, day surgery was not a risk factor for postoperative complications during the COVID-19 pandemic (P = 0.676, OR = 1.154, 95% CI: 0.590–2.257). An increase in age significantly increased the incidence of postoperative surgical complications (P = 0.024, OR = 1.051, 95% CI: 1.007–1.097). At the same time, lymph node dissection after sentinel lymph node biopsy also led to an increase in the incidence of postoperative surgical complications (P = 0.030, OR = 3.372, 95% CI: 1.125–10.106). In the survival curve, no significant difference in DFS was detected between the two groups (P = 0.353). Conclusion Radical mastectomy at day surgery centres is safe and reliable under strict COVID-19 management guidelines.