Incidence and Risk Factors for Seroma after Breast Cancer Surgery in Breast Cancer Patients Receiving Treatment in Photharam Hospital
Abstract
Background: Breast cancer is the most common cancer among Thai women. Surgery is the main treatment that often causes complications after surgery, namely Seroma has an incidence of 3-85%, with several risk factors. This study aim to determine the incidence and risk factors of seroma among breast cancer patients undergoing mastectomy in Photharam Hospital. The results of the study will be important information for risk prevention planning and reduce such complications and be used to create guidelines to prevent the seroma.
Material and Methods: This research is a retrospective analytical study using data from electronic medical records of breast cancer patients undergoing mastectomy in Photharam Hospital, total 115 cases. The study period was from October 1, 2018, to April 30, 2022. By recording and collecting data according to the following topics: Age, Body mass index, Congenital disease, ASA classification, Anti-Coagulant, stage of breast cancer, Number of axillary lymph nodes, Number of malignant axillary lymph nodes, Neoadjuvant Chemotherapy, Surgery method, Placing a drainage tube under the wound after surgery, Time to remove the drainage tube after surgery and record the incidence of seroma.
Result: 115 of breast cancer patients who underwent breast surgery in Photharam Hospital, it was found that all patients had an average age of 58.47 ± 10.89 years, body mass index 25.07 ± 4.43 kg/m2, Number of axillary node 11.23 ± 5.95, Number of malignant axillary node 11.23 ± 5.95, Early Breast Cancer patients were 52 cases (45.2%), 57 cases (49.6%) were locally advanced and 6 (5.2%) metastasis. 22 cases (19.1%) of neoadjuvant chemotherapy, Modified Radical Mastectomy 82 cases (71.3%) and Total Mastectomy with SLNBx 33 cases (28.7%). Patient had a drainage tube inserted under the wound 102 cases (88.7%).The incidence of seroma is 44.3% (51 cases).And not found risk factors are effected on incidence of seroma.
Conclusion: Total mastectomy with sentinel lymph node biopsy in patients with early breast cancer could be developed as a guideline for the care of patients after breast cancer surgery in one-day surgery or ambulatory surgery (ODS) safely.
References
J.Rojanamatin WU, P.Supaattagorn, I. Chiawiriyabunya, M.Wongsena, A.Chaiwerattana, P.Laowahutanont, I.Chitapanarux, P.Vatanasapt, S.L.Greater, S.Sangrajrang, R.Buasom. Cancer in Thailand Vol.X 2016-2018. 2021;X.
Society TBD. Breast Surgical Oncology2018.
Kumar S, Lal B, Misra MC. Post-mastectomy seroma: a new look into the aetiology of an old problem. J R Coll Surg Edinb 1995;40:292-294.
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.
Kopelman D, Klemm O, Bahous H, Klein R, Krausz M, Hashmonai M. Postoperative suction drainage of the axilla: for how long? Prospective randomised trial. Eur J Surg 1999;165:117-120; discussion 121-112.
Hashemi E, Kaviani A, Najafi M, Ebrahimi M, Hooshmand H, Montazeri A. Seroma formation after surgery for breast cancer. World J Surg Oncol 2004;2:44.
Sampathraju S, Rodrigues G. Seroma formation after mastectomy: pathogenesis and prevention. Indian J Surg Oncol 2010;1:328-333.
Mancaux A, Naepels P, Mychaluk J, Abboud P, Merviel P, Fauvet R. [Prevention of seroma post-mastectomy by surgical padding technique]. Gynecol Obstet Fertil 2015;43:13-17.
Watt-Boolsen S, Nielsen VB, Jensen J, Bak S. Postmastectomy seroma. A study of the nature and origin of seroma after mastectomy. Dan Med Bull 1989;36:487-489.
Pogson CJ, Adwani A, Ebbs SR. Seroma following breast cancer surgery. Eur J Surg Oncol 2003;29:711-717.
Services USDoHaH. Common Terminology for Adverse Events (CTCAE) Version 5.0. 2017.
Zielinski J, Jaworski R, Irga N, Kruszewski JW, Jaskiewicz J. Analysis of selected factors influencing seroma formation in breast cancer patients undergoing mastectomy. Arch Med Sci 2013;9:86-92.
F Charles Brunicardi DKA, Timothy R Billiar ,David L Dunn, John G Hunter. Schwartz's principles of surgery: New York : McGraw-Hil; 2019.
Murphey DR, Jr. The use of atmospheric pressure in obliterating axillary dead space following radical mastectomy. South Surg 1947;13:372-375.
Thomson DR, Sadideen H, Furniss D. Wound drainage after axillary dissection for carcinoma of the breast. Cochrane Database Syst Rev 2013:CD006823.
Troost MS, Kempees CJ, de Roos MAJ. Breast cancer surgery without drains: no influence on seroma formation. Int J Surg 2015;13:170-174.
Baker E, Piper J. Drainless mastectomy: Is it safe and effective? Surgeon 2017;15:267-271.
Temple-Oberle C, Shea-Budgell MA, Tan M, Semple JL, Schrag C, Barreto M, et al. Consensus Review of Optimal Perioperative Care in Breast Reconstruction: Enhanced Recovery after Surgery (ERAS) Society Recommendations. Plast Reconstr Surg 2017;139:1056e-1071e.
Jogerst K, Thomas O, Kosiorek HE, Gray R, Cronin P, Casey W, 3rd, et al. Same-Day Discharge After Mastectomy: Breast Cancer Surgery in the Era of ERAS((R)). Ann Surg Oncol 2020;27:3436-3445.
Gradishar WJ, Moran MS, Abraham J, Aft R, Agnese D, Allison KH, et al. NCCN Guidelines(R) Insights: Breast Cancer, Version 4.2021. J Natl Compr Canc Netw 2021;19:484-493.
Giuliano AE, Edge SB, Hortobagyi GN. Eighth Edition of the AJCC Cancer Staging Manual: Breast Cancer. Ann Surg Oncol 2018;25:1783-1785.
