Evidence map›Paper›PMID 42286386›Full record

ArticleBreast cancer (Tokyo, Japan)2026

Low protein, high risk: hypoalbuminemia predicts adverse outcomes after mastectomy in 37,848 breast cancer patients.

Thomas Schaschinger, Tobias Niederegger, Fortunay Diatta, Dany Y Matar, Jilian Dean, Doha Obed, Henriette Grundig, Barbara Kern, Christoph Tausch, Solange Bayard and 5 more

Abstract read
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Article in Breast cancer (Tokyo, Japan), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Thomas Schaschinger *Department of Hand-, Plastic and Reconstructive Surgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Microsurgery, Ludwigshafen, Germany.
Tobias Niederegger *Department of Hand-, Plastic and Reconstructive Surgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Microsurgery, Ludwigshafen, Germany.
Fortunay DiattaDivision of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
Dany Y MatarDivision of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Jilian DeanSchool of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Doha ObedDepartment of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany.
Henriette GrundigDepartment of Plastic Surgery, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Barbara KernDepartment of Plastic Surgery, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Christoph TauschBreast Center Zurich, Zurich, Switzerland.
Solange BayardBreast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Giacomo MontagnaBreast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Dennis P OrgillDivision of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Adriana C PanayiDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Microsurgery, Ludwigshafen, Germany.
Gabriel Hundeshagen *Department of Hand-, Plastic and Reconstructive Surgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Microsurgery, Ludwigshafen, Germany.
Samuel A Knoedler *Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA. sknoedler@bwh.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypoalbuminemia is a well-known marker of poor nutritional status and has been linked to adverse outcomes in various surgical specialties. However, its role in mastectomy remains underexplored. This study investigates the impact of hypoalbuminemia on 30-day postoperative outcomes in patients undergoing mastectomy for breast cancer.

methodsUsing data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2011 to 2021, we identified 37,848 female breast cancer patients who underwent mastectomy without concurrent reconstructive procedures and had documented preoperative serum albumin levels measured within 30 days of surgery. Patients were stratified by albumin level (< 3.5 g/dL vs. ≥3.5 g/dL). Multivariate logistic regression was used to assess the association between hypoalbuminemia and postoperative 30-day outcomes. ROC analysis identified albumin thresholds predictive of complications.

resultsAmong 37,848 patients, 3,210 (8.5%) were hypoalbuminemic. Hypoalbuminemia was significantly associated with higher rates of any complication (16% vs. 10%; OR 1.4, p < 0.001), surgical complications (10% vs. 5.5%; OR 1.5, p < 0.001), medical complications (0.37% vs. 0.13%; OR 1.8, p < 0.001). Similarly, readmissions were significantly more frequent in hypoalbuminemic patients (7.0% vs. 3.9%; OR 1.6, p < 0.001). The need for transfusion was over three times higher (5.0% vs. 1.4%, p < 0.001), and hypoalbuminemia was associated with longer hospital stays (2.2 vs. 1.3 days, p < 0.001). Subgroup analysis revealed that these trends persisted across both total and radical mastectomy procedures. Optimal albumin thresholds for predicting complications ranged from 3.7 to 4.1 g/dL, depending on the type of complication.

conclusionPreoperative hypoalbuminemia is an independent predictor of increased postoperative morbidity following mastectomy. Clinicians may consider selective albumin assessment as a pragmatic tool for identifying patients with increased physiological vulnerability who may benefit from targeted preoperative optimization strategies, rather than as a stand-alone indicator of nutritional deficiency; however, further research is needed to establish optimal testing strategies and confirm clinical benefits.

Indexed as

Breast NeoplasmsHypoalbuminemiaMastectomyPostoperative ComplicationsAdultAgedFemaleHumansMiddle AgedRetrospective StudiesRisk FactorsSerum AlbuminSerum AlbuminACS-NSQIPAlbuminBreast cancer surgeryBreast removalHypoalbuminemiaMastectomy

Identifiers

PMID42286386

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.