Rajeev Narasimhappa1 , Viraja Bobburi2
BACKGROUND Breast cancer is the second most common cancer in the world and, most frequent cancer among women with an estimated 1.67 million new cancer cases diagnosed in 2012. Breast cancer is the fifth most common cause of death from cancer overall and while it is the most frequent cause of cancer death in women in less developed regions it is now the second cause of cancer death in more developed regions deaths after lung cancer. Most of the cases in India present in locally advanced stage and surgery (Modified Radical Mastectomy) is a major part of the treatment the others being chemotherapy and Radiotherapy. The complications of modified radical mastectomy are numbness, paraesthesia, seroma formation and shoulder immobility. Seroma formation increases the morbidity, repeated aspirations, infection and hospitalization. The incidence of seroma formation varies between 5% and 85%. Its formation depends on the type of surgery, the operating surgeon, preoperative radiation or chemotherapy, the amount of postoperative physical activity, use of cautery use of closed suction drains and closure of dead space have been implicated as potential factors influencing the likelihood of seroma formation. METHODS It is a prospective study of 50 patients. The incidence of seroma formation and the factors influencing it were analysed. RESULTS 50 patients who underwent modified radical mastectomy were studied. 18 patients (36%) developed seroma. Out of 18 patients who developed seroma, 10 patients (55.56%) had diabetes 14 patients (70%) had hypertension, 10 patients (55,56%) had received NACT. The mean BMI of those with seroma was 26.55 (20-34); the mean drain removal day of those with seroma was 13.28 days (7-19), whereas the mean for patients without seroma was 6.38 days (4-10). CONCLUSIONS DM, hypertension have significant association with seroma formation. Higher BMI has strong association for seroma formation. With larger tumour size, chances of seroma formation is high. High drain output on post-operative day 1, POD 2, POD 3 is likely to predict increased seroma formation. Age of the patient, tumour side, NACT, preoperative RT, number of lymph nodes removed, have no bearing on seroma rate.
