Outcomes of Concurrent Prophylactic Mastectomy and Oophorectomy, Compared to Mastectomy and Hysterectomy, in Hereditary Breast and Gynecologic Cancer: A National Surgical Quality Improvement Program Database Analysis

Objective: The aim of this research was to assess outcomes of concurrent prophylactic mastectomy and oophorectomy, compared to prophylactic mastectomy and hysterectomy, in patients with hereditary breast and gynecologic cancers. Materials and Methods: This retrospective cohort study of perioperative outcomes used the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Of 4673 women undergoing prophylactic mastectomy in the dataset, 82 (1.75%) had concurrent mastectomy and oophorectomy, while 46 (0.98%) had concurrent mastectomy and hysterectomy. Concurrent mastectomy and oophorectomy was compared with concurrent mastectomy and hysterectomy, for outcomes of prophylactic procedures. Results: There were 82 cases of concurrent mastectomy and oophorectomy and 46 cases of concurrent mastectomy and hysterectomy. No significant differences in age (mean ± standard deviation: 46.37 ± 9.00 versus 44.00 ± 8.66 years), normal body mass index (45.12% versus 45.65%), nonsmoking status (82.93% versus. 89.13%), diabetes (3.66% versus 0.00%), classified American Society of Anesthesiologists I (17.07% versus 26.09%), and preoperative hematocrit (38.39 ± 3.51 versus 37.05 ± 6.69) were found. Concurrent mastectomy and hysterectomy were more likely to be inpatient surgeries (86.96% versus. 69.51%; p < 0.05), compared to concurrent mastectomy and oophorectomy. There were no significant differences in rates of surgical-site infections, sepsis, wound disruptions, pelvic visceral injury, intraoperative and postoperative transfusions, and reoperations. Conclusions: Surgical outcomes are similar when comparing concurrent mastectomy and hysterectomy to mastectomy and oophorectomy. The NSQIP data suggest either strategy does not increase surgical and medical complications perioperatively. (J GYNECOL SURG 38:148)