Maintaining good practice in breast cancer management and reducing the carbon footprint of care: study protocol and preliminary results

Abstract

Objective: Health care accounts for up to 8-10% of greenhouse emission yearly in the US and surgical room contributes an estimated 25-30% of hospital waste. Despite the major role of greenhouse emissions because of surgery, little has been done by surgeons to reduce their impact. In this paper, we present a multicentric retrospective analysis to evaluate the carbon footprint of the most common breast surgical treatment and a preliminary analysis of our results. Patients and Methods: Retrospective analysis with processed-based life cycle assessment (LCA) has been obtained to determine carbon footprint of different surgical procedures. In our preliminary study, we enrolled all consecutive patients undergoing breast conserving procedure (BCP) between 9th March 2019 and 9th March 2021 to underline the reduction in fuel consumption with postoperative telehealth application (pre-COVID-19 vs. COVID-19). A propensity score matching was implemented to optimize comparability. Results: From 276 BCP patients, PSM included 69 pre-COVID-19 and 69 COVID-19 groups, respectively. No statistically significant difference was found in the tumor stage, marital status, and distance from the hospital. A total of 466 postoperative visits was performed and a statistically significant difference in telehealth visit rate was found between groups (1.75% vs. 51.68%; p<0.001). A reduction of 4312.38 km in travel to the hospital was found in the COVID-19 group. No difference was found in postoperative complications. Conclusions: Health systems worldwide are implementing zero-carbon programs to reduce their carbon footprint. Breast surgeons should consider the consequences of their actions and embrace the pillars of the circular economy. Our data could promote further action in order to raise awareness regarding carbon footprint of breast surgery.

Keywords

• awake breast surgery
• breast cancer
• breast cancer treatment
• breast surgery
• carbon footprint
• covid-19