Incidence and predictors of postoperative complications in breast oncological surgery: A single-center retrospective study

Background Postoperative mortality and morbidity are important quality markers of surgical care. We aimed to evaluate the type and incidence of postoperative complications and relevant risk predictors. Methods This retrospective study included patients with invasive breast cancer or ductal carcinoma in situ. Postoperative complications were categorized by the Clavien–Dindo classification. Univariable and multivariable analyses were performed to identify risk predictors. Results A total of 103 patients (44%) experienced at least one postoperative complication. Grade I complications occurred in 7.7% of patients and grade II in 10.3%. Seroma requiring aspiration, classified as Clavien–Dindo grade IIIa, was the most frequent complication and occurred in 74 patients (31.6%). On multivariable analysis, axillary lymph node dissection (p = 0.002, OR 3.88, 95% CI 1.62–9.27) and mastectomy with immediate breast reconstruction (p = 0.01, OR 5.0, 95% CI 1.46–17.09) were independent predictors of postoperative complications, whereas HER2-positive disease (p = 0.037, OR 0.08, 95% CI 0.01–0.85) was associated with lower odds of postoperative complications; however, this finding should be interpreted with caution given the small number of HER2-positive cases. Conclusion The overall incidence of postoperative complications was high. Axillary lymph node dissection and mastectomy with immediate breast reconstruction were independently associated with increased postoperative morbidity. HER2-positive disease was associated with lower odds of complications, a finding that should be regarded as hypothesis-generating.