Welcome to the Breast Cancer Surgery Risk Calculator

Instructions

Each complication tab on the pre-operative questionnaire page provides probabilities for that chosen complication category.

• After inputting the patient's unique patient demographic information, press the calculate button on the right side, under RESULTS, to view the patient's complication result.
• The overall complication probability accounts for any possible complication whereas the other complication categories are specific for that complication group.
• Each complication group is a different statistic model providing risk information specific to the complications in that group.
• Each model only accounts for acquiring one complication, thus the Infectious, Hematologic, or Internal Organ complication probabilities may sum to be a lower probability then the Overall risk probability.
• This may occur because some patients may or may not acquire one or more complications in two different complication groups and the Overall complication group only accounts for one complication.

The output will provide a predicted probability for developing an Overall, Infectious, Hematologic, or Internal Organ Complication within 30 Days after surgery in the Results Tab.

• These probabilities are unique to the patient and the information you put into each question.
• The patient's inputted demographic information is preserved as you switch between the complication tabs. If you change any demographic variable setting, (e.g. Smoker: YES ➡ NO), then make sure to recalculate the patient's complication result probabilities by pressing the calculate button again for each complication category of interest.

Explanations of Variables in Pre-Operative Questionnaire

Functional status? Does the patient need assistance with their daily routine?

• Independent if they do not require assistance from another person for any activities of daily living.
• Partially dependent if the patient requires some assistance from another person for activities of daily living (includes patients who utilize prosthetic equipment or devices but still requires some assistance from another person).
• Fully dependent if the patient requires total assistance for all activities of daily living.

Is the patient being treated for hypertension or high blood pressure?

• Treatment for high blood pressure refers to medications that can lower you blood pressure. Not limiting to these but common examples are beta-blockers (atenolol, metoprolol), diuretics (furosemide, hydrochlorothiazide), alpha blockers (doxazosin), calcium channel blockers (amlodipine, diltiazem, verapamil), ace inhibitors (enalapril, lisinopril).

Does the patient have a bleeding disorder or take anticoagulation medication?

• Some bleeding disorders include vitamin K deficiency, hemophilia’s, and thrombocytopenia.
• Blood thinning medications are anticoagulant medications, common examples, but not limited to, are: warfarin, argatroban, or heparin therapy that has not been discontinued prior to surgery.
• If you only take ASPIRIN state No (aspirin is not included as a blood thinning medication).

Is the patient having lymph node surgery?

• Lymph node surgery is very common in breast surgery to make sure that the cancer is not spreading. Only patients who are diagnosed with Invasive cancer need to have lymph node surgery. At a minimum patients need to have a sentinel lymph node removed when diagnosed with Invasive cancer. The patient's surgeon or oncologist can inform the patient if they need to have an axillary lymph node dissection.
• Patients diagnosed with DCIS do NOT need any lymph node surgery. These are national guidelines.

Will the patient have a drain or wound assist device after surgery?

• After surgery there is a lot of swelling and healing involved. Some surgeons use drains for a temporary period to remove some fluid and it is later removed. Also, some surgeons may place a vacuum seal device which uses a vacuum to remove fluid. Ask the patient's surgeon for more information.

References

Surgical Predictive Model for Breast Cancer Patients Assessing Acute Postoperative Complications:
The Breast Cancer Surgery Risk Calculator

View Manuscript

Manuscript:

Jonczyk MM, Fisher C, Babbitt R, Margenthaler JA, Czerniecki B, Paulus J, Freund K, Losken A, Chatterjee A. Surgical predictive model for breast cancer patients assessing acute post-operative complications: the Breast Cancer Surgery Risk Calculator. Annals of Surgical Oncology. DOI: 10.1245/s10434-021-09710-8

Presented at the following National Meeting:

Jonczyk MM, Fisher C, Babbitt R, Margenthaler JA, Paulus J, Freund K, Losken A, Chatterjee A. The surgical risk calculator predicting four acute post-operative complications: the Breast Cancer Surgery Risk Calculator (BCSRc). ACS Clinical Congress October 4-8, 2020.

Author Contributions:

The authors would like to thank Tigran Melkonian, MS (Northeastern University), for his invaluable contributions in the development of the Shiny risk calculator and online web platform.