74 Lessons Learned From a Breast Surgery ERAS Program in an Oncologic Ambulatory Center

Publication
Article
Miami Breast Cancer Conference® Abstracts Supplement42nd Annual Miami Breast Cancer Conference® - Abstracts
Volume 39
Issue 4
Pages: 56

74 Lessons Learned From a Breast Surgery ERAS Program in an Oncologic Ambulatory Center

74 Lessons Learned From a Breast Surgery ERAS Program in an Oncologic Ambulatory Center

Background/Significance

Enhanced Recovery After Surgery (ERAS) protocols have revolutionized surgical care, aiming to optimize patient outcomes and reduce recovery time. In the realm of breast surgery, ERAS implementation in an ambulatory setting presents unique challenges and opportunities. Key components of the ERAS protocol included multimodal pain management, early mobilization, postoperative nausea and vomiting (PONV) prophylaxis, and optimized fluid management. Several elements were updated over the years. This study aims to share our experiences and lessons learned from implementing an ERAS program for breast surgery in a high-volume ambulatory center.

Design and Methods

We retrospectively reviewed 8721 patients who underwent breast surgery between January 2016 and December 2023. The cases were performed with an ERAS protocol. We collected data on surgical volume, intraoperative and postoperative opioids measured in morphine milligram equivalents (MME), length of stay, PONV, and postoperative complications, which included transfers to main hospital and 30-day urgent care center visits.

Status

The volume increased 47% between 2016 and 2023. The implementation of the ERAS protocol resulted in significant reductions in intraoperative and postoperative opioid requirement (29% and 19%), PONV (41%), transfer (49%), 30-day urgent care center visits (43%), and 30-day readmissions (37%). There were no significant changes to length of stay.

The ERAS protocol implementation and improvement was associated with reduction in adverse outcomes despite substantial increase in the volume of cases. ERAS implementation in an ambulatory setting for breast surgery is feasible and can lead to substantial benefits for patients. However, challenges such as education, adherence to preoperative fasting guidelines, and managing unexpected complications remain. By addressing the unique challenges and tailoring the protocol to the ambulatory setting, optimal outcomes can be achieved. Future research should focus on further refining ERAS protocols and exploring innovative strategies to enhance patient outcomes.

Articles in this issue

74 Lessons Learned From a Breast Surgery ERAS Program in an Oncologic Ambulatory Center
74 Lessons Learned From a Breast Surgery ERAS Program in an Oncologic Ambulatory Center
75 Comparing 21-Gene Assay Recurrence Scores Before and After Preoperative Radiation Boost in Patients Enrolled in a Phase 2 Prospective Clinical Trial
75 Comparing 21-Gene Assay Recurrence Scores Before and After Preoperative Radiation Boost in Patients Enrolled in a Phase 2 Prospective Clinical Trial
76 Electromagnetic Chip Bracketed vs Wire Bracketed Localization in Breast Conserving Surgery
76 Electromagnetic Chip Bracketed vs Wire Bracketed Localization in Breast Conserving Surgery
77 A Radio Opaque Suture May Improve Radiation Target Delineation in Post Lumpectomy Patients With Breast Cancer: A Retrospective Analysis
77 A Radio Opaque Suture May Improve Radiation Target Delineation in Post Lumpectomy Patients With Breast Cancer: A Retrospective Analysis
78 Comparison of Positive Margin Rate of Breast Cancer in Higher BMI Patients
78 Comparison of Positive Margin Rate of Breast Cancer in Higher BMI Patients
79 Case Series of Pathologic Upgrade After Reconstructive Breast Surgery
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81 Assessing Recurrence Likelihood in Hormone Receptor–Positive/HER2-Negative Breast Cancer Patients Directly From MRI Using Imaging AI
81 Assessing Recurrence Likelihood in Hormone Receptor–Positive/HER2-Negative Breast Cancer Patients Directly From MRI Using Imaging AI
82 Efficacy, Safety, and Biomarker Analysis of ICARUS-BREAST01: A Phase 2 Study of Patritumab Deruxtecan (HER3-DXd) in Patients With HR+/HER2– Advanced Breast Cancer
82 Efficacy, Safety, and Biomarker Analysis of ICARUS-BREAST01: A Phase 2 Study of Patritumab Deruxtecan (HER3-DXd) in Patients With HR+/HER2– Advanced Breast Cancer
TPS 83 ELAINE 3: Open-Label, Randomized, Multicenter, Phase 3 Study of the Efficacy and Safety of Lasofoxifene Plus Abemaciclib for Treating Locally Advanced or Metastatic, ER+/HER2–, Breast Cancer With an ESR1 Mutation
TPS 83 ELAINE 3: Open-Label, Randomized, Multicenter, Phase 3 Study of the Efficacy and Safety of Lasofoxifene Plus Abemaciclib for Treating Locally Advanced or Metastatic, ER+/HER2–, Breast Cancer With an ESR1 Mutation
84 EQUALS: Vaginal/Sexual Health in Patients With Estrogen Receptor–Positive/HER2- Metastatic Breast Cancer
84 EQUALS: Vaginal/Sexual Health in Patients With Estrogen Receptor–Positive/HER2- Metastatic Breast Cancer
86 Elacestrant Combinations in Patients With Estrogen Receptor-Positive, HER2-Negative Locally Advanced or Metastatic Breast Cancer: Update From ELEVATE, a Phase 1b/2, Open-Label, Umbrella Study
86 Elacestrant Combinations in Patients With Estrogen Receptor-Positive, HER2-Negative Locally Advanced or Metastatic Breast Cancer: Update From ELEVATE, a Phase 1b/2, Open-Label, Umbrella Study
87 Elacestrant Plus Abemaciclib Combination in Patients With Estrogen Receptor-positive, HER2-Negative Advanced or Metastatic Breast Cancer
87 Elacestrant Plus Abemaciclib Combination in Patients With Estrogen Receptor-positive, HER2-Negative Advanced or Metastatic Breast Cancer
88 Eflapegrastim, a Long-Acting Granulocyte Colony–Stimulating Factor, Administered the Same Day as Chemotherapy in Patients With Early-Stage Breast Cancer: Results From a Multicenter, Open-Label Study
88 Eflapegrastim, a Long-Acting Granulocyte Colony–Stimulating Factor, Administered the Same Day as Chemotherapy in Patients With Early-Stage Breast Cancer: Results From a Multicenter, Open-Label Study
TPS 89 A Randomized Phase 3 Study of First-Line Saruparib (AZD5305) Plus Camizestrant Versus CDK4/6i Plus Physician’s Choice Endocrine Therapy or CDK4/6i Plus Camizestrant in Patients With HR+/HER2– Advanced Breast Cancer With BRCA1/BRCA2/PALB2 Mutations (EvoPAR-B)
TPS 89 A Randomized Phase 3 Study of First-Line Saruparib (AZD5305) Plus Camizestrant Versus CDK4/6i Plus Physician’s Choice Endocrine Therapy or CDK4/6i Plus Camizestrant in Patients With HR+/HER2– Advanced Breast Cancer With BRCA1/BRCA2/PALB2 Mutations (EvoPAR-B)
90 Contralateral Risk Reduction Mastectomy in Patients With Unilateral Breast Cancer: A Multinational and Multidisciplinary Survey—Physicians’ Perspective
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