Breasts

In reference 1, an article based on the book at reference 2, I was rather taken aback to read that in the US, in 2013, 45% of mastectomies were performed as what we would call day cases. Otherwise, out-patient or ambulatory. The allegation being first that this was often unpleasantly, not to say dangerously, inappropriate and second that this was a consequence of most health care in the US being delivered for profit, mostly paid for by insurance, rather than as a public service, mostly paid for from general taxation.

I was pointed to a paper coming from the Agency for Healthcare Research and Quality, the people at reference 4. From there I quickly got to reference 3, probably not quite the right place, but quite good enough. Statistical Brief #201.

From Table 2 of which (snapped above) I learn that over the period 2005-2013 ambulatory breast cancer surgery has become a much larger proportion of the total, to about one third of all bilateral mastectomies and about one half of all unilateral mastectomies.

Now while it may well be true that there is a lot to be said for ambulatory surgery and that it can now be used for many more procedures than used to be the case, these proportions do seem high to this layman.

The story here in the UK, as explained at reference 5, seems to be that patients usually go home the following day, to recover for some weeks at home. But some go home the same day and some might stay in hospital for a week.

I shall try to find out more.

Reference 1: Cancer under capitalism - Nellie Hermann, NYRB - November 5, 2020.

Reference 2: The undying: Pain, Vulnerability, Mortality, Medicine, Art, Time, Dreams, Data, Exhaustion, Cancer, and Care - Anne Boyer - 2019

Reference 3: Trends in Bilateral and Unilateral Mastectomies in Hospital Inpatient and Ambulatory Settings, 2005-2013 - Claudia A. Steiner, Audrey J. Weiss, Marguerite L. Barrett, Kathryn R. Fingar, P. Hannah Davis - 2016.

Reference 4: https://hcup-us.ahrq.gov/.

Reference 5: https://www.nhs.uk/conditions/mastectomy/.