Study aim : The objective of this prospective study was to assess the feasi
bility of outpatient breast surgery, the reasons for inpatient procedures (
IPP), the reasons for conversion and the conversion rate, and the postopera
tive morbidity after outpatient procedures (OPP).
Patients and methods : In 1999, among 625 patients eligible for OPP (diagno
stic surgery or conservative curative surgery), OPP was performed in 418 pa
tients (67%) and IPP was performed in 207 patients (33%). The reasons for I
PP rather than OPP were environmental (64%) rather than medical (16%).
Results :The conversion rate to conventional surgery was 12.4% and the defi
nitive OPP rate was 58.6%. The reasons for conversion were more often medic
al (50%) and environmental (21%) than surgical (23%). The morbidity, except
for axillary seroma, was similar for OPP and IPP. The axillary seroma rate
after axillary lymph node dissection was higher with OPP (27.4 vs 16.1%).
Conclusion : OPP is a good alternative to IPP in breast surgery, especially
for diagnostic purposes. OPP is also feasible for partial mastectomy with
axillary lymph node dissection, but patients must be clearly informed about
the risks of axillary morbidity. The patients' quality of life and satisfa
ction index should also be evaluated. (C) 2000 Editions scientifiques et me
dicales Elsevier SAS.