{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:17:54Z","timestamp":1788542274246,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Oncol.","Current Oncology"],"abstract":"<jats:p>Same-day surgery for mastectomy increased in Alberta from 1.7% to 73% in 2022, after implementation of a perioperative pathway in 2016. However, rates of unplanned visits to the emergency department (ED) remained &gt;20%. Previous research explored reasons for this using administrative data but lacked patient-level data. Our study aims to explore patient-reported factors influencing unplanned ED visits after mastectomy. A survey study was conducted of patients who underwent mastectomy in Alberta between July 2021 and June 2022. Patients were identified from the Canadian Institute of Health Information database; chart review was performed to confirm ED visit details. Survey questions evaluated medical, socioeconomic, and psychologic domains, as well as patient-reported experiences of perioperative care. Of 556 patients who underwent mastectomy during the study period, 23% presented to the ED unplanned within 30 days. The survey was sent to 87 patients meeting inclusion criteria; 38% responded. Most patients presented on a weekend, stating the ED was the only choice available at the time. The most common patient concerns were related to infection (38%) and drain function (38%). Despite high postoperative ED visit rates, overall, 84% felt prepared for surgery, only 15% felt uncomfortable with drain management, and 78% of patients were satisfied with surgery. Difficulty accessing their surgical team postoperatively was reported as the main challenge. Future initiatives should focus on improved access to outpatient care and education on post-mastectomy emergencies.<\/jats:p>","DOI":"10.3390\/curroncol33090537","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:38:16Z","timestamp":1788539896000},"page":"537","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-Mastectomy Emergency Department Visits in Alberta: Understanding Patient Perspectives"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6594-7949","authenticated-orcid":false,"given":"Emily M.","family":"Heath","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Calgary, Calgary, AB T2N 2T9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Julia","family":"Chai","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2T9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Susan","family":"Isherwood","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Calgary, Calgary, AB T2N 2T9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7826-1133","authenticated-orcid":false,"given":"Riley","family":"Martens Mulangu","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 2T9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Steven","family":"Langer","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Calgary, Calgary, AB T2N 2T9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2603-0411","authenticated-orcid":false,"given":"May Lynn","family":"Quan","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Calgary, Calgary, AB T2N 2T9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3354","DOI":"10.1245\/s10434-019-07568-5","article-title":"Same-Day Surgery for Mastectomy Patients in Alberta: A Perioperative Care Pathway and Quality Improvement Initiative","volume":"26","author":"Keehn","year":"2019","journal-title":"Ann. Surg. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1097\/PRS.0000000000004970","article-title":"Unplanned emergency department visits within 30 days of mastectomy and breast reconstruction","volume":"142","author":"Nasser","year":"2018","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.jamcollsurg.2020.09.015","article-title":"Outpatient mastectomy: Factors influencing patient selection and predictors of return to care","volume":"232","author":"Vuong","year":"2021","journal-title":"J. Am. Coll. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.jgo.2017.10.003","article-title":"Patterns and predictors of emergency department visits among older patients after breast cancer surgery: A population-based cohort study","volume":"9","author":"Westley","year":"2018","journal-title":"J. Geriatr. Oncol."},{"key":"ref_5","unstructured":"Canadian Institute for Health Information (2024). NACRS Emergency Department Visits and Lengths of Stay, Canadian Institute for Health Information. Available online: https:\/\/www.cihi.ca\/en\/nacrs-emergency-department-visits-and-lengths-of-stay."},{"key":"ref_6","first-page":"6","article-title":"Recognizing the emergency department\u2019s role in oncologic care: A review of the literature on unplanned acute care","volume":"1","author":"Lash","year":"2022","journal-title":"Emerg. Cancer Care"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"193e","DOI":"10.1097\/PRS.0000000000000319","article-title":"Risk of readmission following immediate breast reconstruction: Results from the 2011 American College of Surgeons National Surgical Quality Improvement Program data sets","volume":"134","author":"Nelson","year":"2014","journal-title":"Plast. Reconst. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1097\/01.SLA.0000081094.66659.c3","article-title":"Hospital volume, length of stay, and readmission rates in high-risk surgery","volume":"238","author":"Goodney","year":"2003","journal-title":"Ann. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"116","DOI":"10.5999\/aps.2014.41.2.116","article-title":"Predictors of readmission after inpatient plastic surgery","volume":"41","author":"Jain","year":"2014","journal-title":"Arch. Plast. Surg."},{"key":"ref_10","first-page":"1","article-title":"30-day readmission score after cardiac surgery","volume":"20","author":"Espinoza","year":"2016","journal-title":"Clin. Trials Regul. Sci. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1097\/SLA.0000000000001536","article-title":"Rates and risk factors for unplanned emergency department utilization and hospital readmission following bariatric surgery","volume":"263","author":"Telem","year":"2016","journal-title":"Ann. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"6499","DOI":"10.1245\/s10434-023-13727-6","article-title":"Investigating factors associated with postmastectomy emergency department visits: A population-based analysis","volume":"30","author":"Langer","year":"2023","journal-title":"Ann. Surg. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/1062860613487196","article-title":"Emergency department utilization as a measure of physician performance","volume":"29","author":"Dowd","year":"2014","journal-title":"Am. J. Med. Qual."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1111\/j.1553-2712.2011.01223.x","article-title":"Emergency medicine\u2013quality indicators: The United Kingdom practice","volume":"18","author":"Heyworth","year":"2011","journal-title":"Acad. Emerg. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.amjsurg.2009.10.010","article-title":"Post-appendectomy visits to the emergency department within the global period: A target for cost containment","volume":"200","author":"Aiello","year":"2010","journal-title":"Am. J. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.annemergmed.2013.01.024","article-title":"Emergency department visits after hospital discharge: A missing part of the equation","volume":"62","author":"Rising","year":"2013","journal-title":"Ann. Emerg. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1001\/jama.2012.216219","article-title":"Use of hospital-based acute care among patients recently discharged from hospital","volume":"309","author":"Vashi","year":"2013","journal-title":"JAMA"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1056\/NEJMoa020128","article-title":"Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation","volume":"347","author":"Fisher","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/S1470-2045(10)70207-2","article-title":"Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: Overall survival findings from the NSABP B-32 randomised phase 3 trial","volume":"11","author":"Krag","year":"2010","journal-title":"Lancet Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1001\/jama.2017.11470","article-title":"Effect of axillary dissection vs no axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis: ACOSOG Z0011 (Alliance) randomized clinical trial","volume":"318","author":"Giuliano","year":"2017","journal-title":"JAMA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s13741-020-00155-3","article-title":"Pain and haemorrhage are the most common reasons for emergency department use and hospital admission in adults following ambulatory surgery: Results of a population-based cohort study","volume":"9","author":"Sawhney","year":"2020","journal-title":"Perioper. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s12245-015-0082-3","article-title":"Unplanned 3-day re-attendance rate at emergency department (ED) and hospital\u2019s bed occupancy rate (BOR)","volume":"8","author":"Sun","year":"2015","journal-title":"Int. J. Emerg. Med."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Hitzek, J., Fischer-Rosinsky, A., Mockel, M., Kuhlmann, S.L., and Slagman, A. (2022). Influence of weekday and seasonal trends on urgency and in-hospital mortality of emergency department patients. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.711235"},{"key":"ref_24","first-page":"e21.00209","article-title":"Unplanned emergency and urgent care visits after orthopaedic surgery","volume":"5","author":"Williams","year":"2021","journal-title":"J. Am. Acad. Orthop. Surg. Glob. Res. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1016\/j.arth.2017.10.040","article-title":"A consultation phone service for patients with total joint arthroplasty may reduce unnecessary emergency department visits","volume":"33","author":"Saku","year":"2018","journal-title":"J. Arthroplast."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1097\/01.blo.0000533620.66105.ef","article-title":"Does orthopaedic outpatient care reduce emergency department utilization after total joint arthroplasty?","volume":"476","author":"Chaudhary","year":"2018","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2480","DOI":"10.1245\/s10434-016-5128-0","article-title":"Same-day major breast cancer surgery is safe: An analysis of short-term outcomes using NSQIP data","volume":"23","author":"Cordeiro","year":"2016","journal-title":"Ann. Surg. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"221","DOI":"10.3233\/BD-150412","article-title":"Predictors of 30-day readmission after mastectomy: A multi-institutional analysis of 21,271 patients","volume":"35","author":"Chow","year":"2015","journal-title":"J. Breast Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"S459","DOI":"10.1245\/s10434-015-4741-7","article-title":"Reoperation for complications after lumpectomy and mastectomy for breast cancer from the 2012 National Surgical Quality Improvement Program (ACS-NSQIP)","volume":"22","author":"Thomsen","year":"2015","journal-title":"Ann. Surg. Oncol."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/9\/537\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:47:19Z","timestamp":1788540439000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/9\/537"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":29,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["curroncol33090537"],"URL":"https:\/\/doi.org\/10.3390\/curroncol33090537","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]}}}