A PROSPECTIVE EVALUATION OF SEROMA FREQUENCY AND DETERMINANTS FOLLOWING MODIFIED RADICAL MASTECTOMY IN A TERTIARY HOSPITAL OF NORTH INDIA
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Keywords
Seroma, Modified Radical Mastectomy, Breast Cancer Surgery, Postoperative Complications, Risk Factors, Body Mass Index, Hypertension
Abstract
Background: Seroma formation is one of the most frequent early postoperative complications following modified radical mastectomy (MRM). Although often self-limiting, seroma can contribute to delayed wound healing, increased risk of infection, prolonged hospitalization, and postponement of adjuvant therapy. Identifying factors associated with seroma is essential to improve postoperative outcomes.
Aim: To determine the incidence of seroma following MRM and assess patient- and surgery-related risk factors associated with its development.
Methods: A prospective observational study was conducted over 18 months at a tertiary-care teaching hospital. Sixty female breast cancer patients undergoing MRM were consecutively enrolled. Demographic variables, comorbidities, tumor stage, and operative details were recorded. Seroma occurrence within 30 postoperative days was assessed clinically and confirmed by aspiration or ultrasonography when indicated. Statistical analysis was performed using SPSS v26. Variables with p < 0.05 on univariate analysis were included in multivariate logistic regression to determine independent predictors.
Results: Seroma developed in 24 of 60 patients, yielding an incidence of 40%. Mean time to seroma detection was 6.0 ± 2.4 days. On univariate analysis, BMI ≥ 28 kg/m² (p = 0.018) and hypertension (p = 0.041) were significantly associated with seroma. Both BMI ≥ 28 kg/m² (OR = 1.15; 95% CI: 1.01–1.32; p = 0.027) and hypertension (OR = 3.85; 95% CI: 1.05–14.15; p = 0.042) remained independent predictors in multivariate analysis. Age, diabetes mellitus, tumor stage, and duration of surgery showed no significant associations.
Conclusion: Seroma formation is common after MRM, occurring in 40% of cases. Elevated BMI and hypertension are significant independent predictors. Identifying high-risk patients preoperatively may guide tailored peri-operative strategies to reduce seroma incidence and enhance postoperative outcomes.
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Dr Jatin Rathore
Post Graduate Resident, Department of General Surgery, Government Medical College, Jammu, India
Dr Suraj Sahu
Post Graduate Resident, Department of General Surgery, Government Medical College, Jammu, India
Dr Aditya Chaubey
Post Graduate Resident, Department of Orthopaedics, Government Medical College, Jammu, India
Dr Jatin Prajapati
Post Graduate Resident, Department of Community Medicine, RNT Medical College, Udaipur, Rajasthan, India