DOI: http://dx.doi.org/10.18203/2349-2902.isj20203768

A prospective study of factors affecting seroma formation after modified radical mastectomy in patients of carcinoma of breast

Anuradha Chaudhary, Sonveer Gautam

Abstract


Background: Seroma, a clinically evident subcutaneous collection of serous fluid after breast cancer surgery, developing in approximately 30% of cases. To prevent seroma formation, it is important to estimate individual risk of seroma formation, i.e., the identification of predictive variables will be helpful in designing future trials aimed at reducing the incidence of this seroma. This study intends to find out the association between certain pre-operative, intra-operative, and post-operative factors related to MRM and incidence of seroma formation.

Methods: It was an observational prospective on 100 females undergoing MRM at Department of Gandhi Medical College Bhopal, Madhya Pradesh, India. Patients were observed postoperatively for seroma formation and factors affecting it.

Results: patients with seroma formation in this study tended to be older age (age, 62.60±10.40 years versus 56.13±10.31 years; p<0.001) and more obese (BMI, 26.95±4.2 versus 24.61±3.61; p<0.001). Higher amount of initial drain volume was directly related to seroma formation.  Initiation of arm physiotherapy after surgery (3.14±0.23 days versus 2.17±0.74 days; p=0.043).

Conclusions: The incidence of seroma is higher in older and in more obese patients. The incidence is decreased by flap fixation under muscles and early physiotherapy. Furthermore, few interventions in the operative period can help minimize the chances of seroma formation.


Keywords


Carcinoma breast, Modified radical mastectomy, Seroma

Full Text:

PDF

References


Hunt KK, Green MC, Buchholz TA. Diseases of the breast. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, editors. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:823-826,834-836,840-841.

Lester SC. The breast. In: Kumar V, Abbas AK, Fausto N, editors. Robbins and Cotr an Pathologic Basis of Disease. 7th ed. Philadelphia, PA: Elsevier; 2006: 1129-1130.

Kosecoff J, Kanouse DE, Brook RH. Changing practice patterns in the management of primary breast cancer: Consensus development program. Health Serv Res. 1990;25:809-23.

Douay N, Akerman G, Clément D, Malartic C, Morel O, Barranger E. Seroma after axillary lymph node dissection in breast cancer. Gynecol Obstet Fertil. 2008;36:130-5.

Dawson I, Stam L, Heslinga JM, Kalsbeek HL. Effect of shoulder immobilization on wound seroma and shoulder dysfunction following modified radical mastectomy: A randomized prospective clinical trial. Br J Surg. 1989;76:311 2.

Barwell J, Campbell L, Watkins RM, Teasdale C. How long should suction drains stay in after breast surgery with axillary dissection? Ann R Coll Surg Engl. 1997;79:435-7.

Bryant M, Baum M. Postoperative seroma following mastectomy and axillary dissection. Br J Surg. 1987;74:1187.

Lin YP, Yin WJ, Yan TT, Zhou LH, DI GH, Wu J, et al. Risk factors for postoperative seromas in Chinese breast cancer patients. China Med J. 2011;124:1300-4.

Menton M, Roemer VM. Seroma formation and drainage technic following mastectomy. Fortschr Med. 1990 20;108:350-2.

Burak WE Jr, Goodman PS, Young DC, Farrar WB. Seroma formation following axillary dissection for breast cancer: Risk factors and lack of influence of bovine thrombin. J Surg Oncol. 1997;64:27-31.

Van Bemmel AJ, Van de Velde CJ, Schmitz RF, Liefers GJ. Prevention of seroma formation after axillary dissection in breast cancer: a systematic review. Eur J Surg Oncol. 2011;37(10):829-35.

Anjani J, Amit O, Kuber S, Achal G. Factors affecting seroma formation after modified radical mastectomy in patients of carcinoma breast: A prospective study. IJSS J Surg. 2016;2(1):1-5.

Townsend CM, Beauchamp RD, Evers BM, Mattox KL, editors. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. Vol 1, 18th edition. Philadelphia, PA: Elsevier Saunders; 2007:868

Qingqing He, MD, PhD, Department of Thyroid andBreast Surgery, Jinan Military General Hospital of PLA, No. 25 Shifan Road, Jinan 250031 peoples republic of China.