Cancer Research Lab

Infections at the incision site are common after breast surgical procedures, especially after cancer-related breast surgery, and these infections result in more than $4,000 extra hospital-related costs per patient, according to research reported in the January Archives of Surgery.

Dr. Margaret A. Olsen of Washington University School of Medicine, St. Louis and colleagues retrospectively studied 949 women who underwent mastectomy or breast reconstruction procedures between 1999 and 2002 at a hospital affiliated with Washington University.

They found that 50 women (5.3%) developed surgical site infections during the original surgical admission or within 1 year of surgery. The average time between surgery and diagnosis of infection was 46.6 days.

“Surgical site infection after breast cancer surgical procedures was more common than expected for clean surgery and more common than surgical site infection after non-cancer related breast surgical procedures,” the investigators report.

The incidence of surgical site infection was 12.4% following mastectomy with immediate implant reconstruction, 6.2% following mastectomy with immediate reconstruction using a transverse rectus abdominis myocutaneous flap, 4.4% following mastectomy only, and 1.1% following breast reduction surgery.

Dr. Olsen and colleagues also found that women who developed a surgical site infection had significantly longer hospital stays and significantly higher hospital costs compared with those who did not.

After adjusting for the type of surgery performed, breast cancer stage and other factors that influence cost, hospital-associated costs of surgical site infections were $4,091 per patient. As this figure does not include physician costs or costs incurred due to extra clinic visits, outpatient procedures, outpatient antibiotic use or home health care, it likely represents “at best, the minimum costs associated with serious surgical site infection,” the investigators point out.

“Interventions to reduce the incidence of surgical site infection following breast cancer surgical procedures are essential to reduce not only morbidity in these patient populations but also costs to the individuals and society,” Dr. Olsen and colleagues conclude.