Factors Influencing Outcomes following Day-Care Mastectomies being Performed for Breast Cancer in a Single Centre in South India.

Abstract

Day-care surgeries aim to optimize healthcare delivery by reducing hospital stays, costs, and improving patient recovery. While widely adopted in other surgical disciplines, breast cancer surgeries-especially mastectomies-are still predominantly managed as inpatient procedures. With advances in anesthesia, pain control, and structured outpatient care, day-care mastectomies are becoming increasingly feasible. This retrospective observational study evaluates clinical and patient-related factors influencing outcomes of day-care mastectomies performed between 2022 and 2024 at Chennai Breast Centre. A total of 302 women with biopsy-proven breast cancer underwent mastectomy, with or without axillary procedures. All patients had preoperative anesthetic evaluation, and surgeries were performed under general or regional anesthesia with pectoral nerve blocks. Postoperative care focused on early mobilization, pain management using multimodal analgesia, and structured discharge protocols. Of the 302 patients, 248 (82.1%) were discharged on the same day, while 54 (17.9%) required overnight stay. Significant factors associated with deferred discharge included presence of multiple comorbidities (p=0.005), higher ASA grades (p=0.016), and recent neoadjuvant chemotherapy (p=0.051). Clinical reasons for overnight stay included high drain output and pain, while patient-related reasons included psychological comfort and long-distance travel. Postoperative complications such as pain and nausea were minimal, with 99.7% reporting no nausea and over 90% reporting mild or no pain. No major readmissions or re-surgeries were recorded. In conclusion, mastectomies can be safely and effectively performed as day-care procedures with appropriate patient selection, structured protocols, and supportive outpatient care. Wider adoption of day-care breast surgeries could enhance resource utilization and patient satisfaction in breast cancer care.