Outcomes of ambulatory breast surgery among Filipino patients with stage I-III invasive breast cancer: a single institution experience in Cebu, Philippines.

Abstract

Background: Breast cancer is currently the most common cancer among females in the Philippines. The changing surgical landscape and COVID-19 pandemic have led to a greater push toward outpatient surgeries. Ambulatory breast cancer surgery has the potential to let surgeons treat patients promptly, minimise healthcare resource utilisation and reduce COVID-19 exposure.

Methods and results: This is a prospective descriptive study involving a total of 102 women who had ambulatory breast surgery from March 2022 to August 2023. Their clinicodemographic and treatment profile were determined and post-operative complications, readmission rate and levels of satisfaction were obtained on post-operative days 7 and 30. Results showed that the most common complication is seroma which occurred in 57 (56.8%) of patients. Only two patients had hematoma and one patient had a wound infection. The majority of the patients did not complain of pain. There were no readmissions. All patients were largely satisfied with the overall healthcare experience.

Discussion: The COVID-19 pandemic has driven healthcare systems to deliver efficient, effective and safe care to breast cancer patients thus the development of ambulatory breast surgery. Early discharge following surgery necessitates a significant shift in the patient's perspective and preoperative education is critical to improve its chances of success. This study also complemented previously published data that patient safety was not compromised by outpatient surgery.

Conclusion: Our study has shown that ambulatory breast surgery is feasible, safe and can be successfully implemented as breast surgery has been transitioned to a predominantly outpatient procedure. These findings hope to establish ambulatory breast surgery as the norm in our healthcare system and to also pave the way for other procedures to be performed in an ambulatory setting.

Description: This study examines the feasibility and safety of ambulatory breast surgery for patients with stage I-III invasive breast cancer at Cebu Doctors' University Hospital between March 2022 and August 2023. With the increasing shift toward outpatient procedures during the COVID-19 pandemic, this approach was implemented to reduce healthcare costs, limit hospital-acquired infections and optimise resource use. The study revealed that early discharge after surgery led to high patient satisfaction, as it allowed individuals to regain control, adjust psychologically and recover more quickly. Effective preoperative counselling and clear postoperative instructions were essential in managing patient expectations and ensuring positive outcomes. The study demonstrated that ambulatory breast surgeries, such as mastectomy and breast-conserving surgery, are associated with low complication rates, including seroma, hematoma and wound infection, consistent with previous research. The primary advantage of this approach is its ability to provide high-quality care while minimising the strain on healthcare resources. It offers a timely and efficient alternative to traditional inpatient procedures. This study advocates for the widespread adoption of ambulatory breast surgery as a standard practice in healthcare, with the potential for extension to other surgical specialties.