The impact of antibiotic prophylaxis on postoperative infections in breast cancer surgery – a retrospective quality assessment

Introduction Breast cancer is the most frequent cancer among women, with surgery playing a central role in the treatment. Various surgical approaches exist, including a growing field of oncoplastic techniques. Despite classified as a clean surgery, breast surgery has higher rates of postoperative infections compared to other clean surgeries. The role of prophylactic antibiotics in preventing infections remains indecisive. Method This study aimed to investigate the correlation between prophylactic antibiotics and postoperative infections in breast cancer surgery. Secondary objectives included assessing the impact of surgical complexity and demographic factors on infection risk. This study included 578 patients with an invasive breast cancer diagnosis undergoing surgery at Skåne University Hospital during year 2022. Patient records were reviewed in Melior to gather information on demographics, surgical type, prophylactic antibiotic administration and postoperative infections. Result The overall postoperative infection rate after breast cancer surgery was 14% and 72% received prophylactic antibiotics. Mastectomy had the highest postoperative infection rate. No significant difference regarding postoperative infection could be observed between the patients who received prophylactic antibiotic treatment and those who did not (p = 0.88). An increased body mass index was significantly correlated with an increased risk of postoperative infection (p = 0.01). Discussion Prophylactic antibiotics were not associated with a decreased risk of developing postoperative infection. The complexity of the procedure may correlate to the risk of developing a postoperative infection but overall no significance was shown in this study. However, demographic factors as higher body mass index was significantly correlated with an increased risk for postoperative infection.