Update on Outpatient Mastectomy: A Review of 88 Cases
Ross, MD, LA, Axelrod, MD, DM, Siegel, MD, BM, Bernik, MD, SF, Friedman, MD, DJ, Goldenberg, MD, B, Neuman, MD, GG, Moe, MD, J, Cyriac, MD, JI, Mathews, MD, DM

Introduction: In May 2003 we presented an abstract with the results of 62 patients who had undergone outpatient mastectomy. The review focused on our complication rate which included nausea and vomiting, intractable pain and unplanned hospital admission.1 An additional 26 mastectomies have been performed since the last review. With this larger sample size we attempted to determine any changes in our outcome.
Methods: Following IRB approval the charts of 86 female outpatients who underwent outpatient mastectomy (surgery and discharge on the same day) from October 1999 through September 2004 were reviewed. . There were a total of 88 mastectomies (two patients returned for a prophylactic mastectomy). Twenty of these included immediate reconstruction using a prosthesis.
Results: All patients were ASA I-III with an age range of 26-78 years. The procedures were performed under general anesthesia with Desflurane, Fentanyl and Propofol. All received Zofran 4-8 mg, 79.5% received pre-operative Percocet 1-2 tablets and 63.6% received intra-operative Toradol 30-60 mg. Average surgical and PACU times for all procedures were 104 minutes and 244 minutes respectively. The chart below shows the complication rate. The rate of nausea and vomiting increased from 8.1% to 12.5%, PACU recovery time remained unchanged and the admission rate decreased from 1.7% to 1.1%. (The only admission was for uncontrolled bleeding in the PACU).
Discussion: With our expanded experience we continue to show a low incidence of complications and in particular a negligible admission rate of 1.1%. Even though the nausea and vomiting rate increased, it did not delay patient discharge. Because of a continued favorable outcome, we feel that mastectomy performed as an outpatient should be offered with the option of immediate prosthetic reconstruction.

1 Ross LA, Axelrod DM, Ediale KR, Siegel BM, Bernik SF, Neuman GG, Mathews DM, Morsy AS, Zhaku B, B.A.: Outpatient Mastectomy: A Review of 62 Cases. Accepted as Poster Presentation. Fifth International Congress on Ambulatory Surgery, May 2003

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