Clinical Scorecard: Impact of Significant Systemic Infections on Oncological Results After Breast Cancer Surgery

At a Glance

Key Highlights

• Major systemic infections within 90 days post-surgery increase risk of distant breast cancer recurrence (HR 1.23).
• Major systemic infections are associated with higher overall mortality (HR 1.47) and breast cancer-specific mortality (HR 1.27).
• No significant association found between major systemic infections and locoregional recurrence.

Guideline-Based Recommendations

Diagnosis

• Monitor for major systemic infections requiring inpatient care within 90 days post breast cancer surgery.

Management

• Ensure timely and effective treatment of postoperative systemic infections to potentially reduce risk of distant recurrence and mortality.

Monitoring & Follow-up

• Follow-up for distant recurrence and survival should begin 90 days after surgery and continue regularly.
• Locoregional recurrence monitoring should start one year post-surgery.

Risks

• Major systemic infections post-surgery increase risk of distant recurrence and death.
• Other major events (stroke, myocardial infarction, pulmonary embolism) were also assessed but primary focus is on systemic infections.

Patient & Prescribing Data

Patients undergoing breast cancer surgery in Sweden between 2008 and 2019

Effective postoperative infection control and management may improve oncological outcomes by reducing distant recurrence and mortality risks.

Clinical Best Practices

• Vigilant postoperative surveillance for systemic infections within the first 90 days after breast cancer surgery.
• Prompt inpatient treatment of systemic infections to mitigate adverse oncological outcomes.
• Integration of multidisciplinary care involving surgical, infectious disease, and oncology teams for postoperative management.
• Use of comprehensive national registries to monitor patient outcomes and complications.

References

• Breast Cancer Database Sweden 3.0 (BCBaSe 3.0)
• Swedish National Breast Cancer Quality Register (NKBC)
• STROBE Guidelines for Observational Studies