Available online 5 May 2023, 102600

– Mastectomy is still a common treatment for breast cancer. The introduction of the Enhanced Recovery After Surgery pathway (ERAS) having proven its benefits for major surgeries has not yet been validated for mastectomy without reconstruction. Our study was conducted to investigate the effects of implementing an ERAS pathway for mastectomies, including the length of hospital stay, postoperative complications and patient satisfaction.

–The study population included all patients who underwent mastectomy without immediate breast reconstruction in the gynecological surgery department of the Tours University Hospital during the year 2020. We compared patients who underwent an ERAS protocol with those who were managed in a standard manner.

– Of the 92 patients managed for mastectomy, 32 were managed in the ERAS group. The two groups were comparable. We found fewer postoperative complications with this protocol in multivariate analysis.

We also obtained a 37% response rate to the satisfaction questionnaires. We did not find any significant difference between the 2 groups.

– There is a trend towards a decrease in the length of hospitalization associated with a decrease in postoperative complications thanks to the implementation of a ERAS protocol for the management of mastectomies. Future studies should focus on both objective clinical outcomes and patient-reported experiences to provide a comprehensive understanding of the effectiveness of ERAS protocols in mastectomy patients

Breast cancer is the most common cancer among women worldwide, with France reporting 58,400 new cases per year. It is also the leading cause of female cancer deaths, accounting for 14% of such deaths [1]. However, the mortality rate is decreasing, thanks to better screening methods and therapeutic developments. The National cancer institute (INCa) report a 5-year overall survival rate.

In recent years, there has been a shift towards a more holistic approach to managing breast cancer patients,

The study population included all patients who underwent mastectomy for cancer or prophylactic mastectomy.

The cohort is monocentric with patients managed by the Tours University Hospital between January 1, 2020 and December 31, 2020.

The indication for mastectomy was determined after discussion of each patient's file in a multidisciplinary oncology consultation meeting.

The study was retrospective and observational.

We excluded patients who underwent bilateral mastectomy, as well as patients who

Between January 1, 2020, and December 31, 2020, 92 patients underwent unilateral mastectomy without IBR in the gynecological surgery department of the Tours University Hospital.

32 patients were managed according to ERAS protocol and 60 patients according to usual protocol, corresponding to the control group.

The implementation of an ERAS program has been shown to have significant effects on the length of stay and presence of postoperative complications in many major surgeries [2]. While breast surgery has a relatively short length of stay, the use of ERAS in this type of procedure is still an interesting subject of study.

The statistical analysis carried in this study showed a trend towards fewer postoperative complications with ERAS program in multivariate analysis without significant statistical

Our findings suggest that the implementation of an ERAS protocol for mastectomy is associated with a decrease in postoperative complications and a trend towards shorter hospital stay. However, further research with a larger sample size is needed to fully assesse the impact of this protocol on patient outcomes. It is also important to evaluate patient satisfaction as a crucial aspect of surgical care. Therefore, future studies should focus on both objective clinical outcomes and patient-reported

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© 2023 Published by Elsevier Masson SAS.