Cannabis Use and Outcomes in Breast Surgery.

[BACKGROUND] The rising prevalence of cannabis use introduces unique considerations for surgical patients, yet its impact in breast surgery remains poorly characterized. This narrative review synthesized available evidence investigating outcomes and postoperative complications associated with cannabis use across breast surgery, including breast reduction, mastectomy, implant-based breast surgery, and autologous breast reconstruction.

[METHODS] A systematic search of PubMed, Embase, Web of Science, and Cochrane Library identified studies reporting clinical outcomes of patients undergoing breast surgery with documented cannabis use.

[RESULTS] Among ten included studies, cannabis use was consistently associated with younger patient age and concomitant nicotine use. Across procedures, cannabis use was variably associated with increased risks of complications. The most salient findings included consistent reports of elevated hematoma risk and wound healing complications, thromboembolic events in autologous tissue breast reconstruction, and infection risk in implant-based breast reconstruction. However, findings were heterogeneous, largely attributable to variability in study design, most notably resulting from nonstandardized definitions of active cannabis use, small sample sizes, and the absence of detailed characterization of cannabis exposure.

[CONCLUSIONS] Cannabis use may increase perioperative risk in implant-based and autologous breast reconstruction, particularly for hematoma, infection, and venous thromboembolism. Cannabis use was not found to significantly impact outcomes in breast reduction and cosmetic breast augmentation. Evidence remains limited by nonstandardized reporting and a lack of prospective studies. Future research incorporating granular, standardized cannabis use assessments is needed to inform risk stratification and perioperative management of this growing patient population.