Post-Mastectomy Seroma- How to Anticipate and Prevent It?

Abstract

BACKGROUND Seroma formation is the commonest complication of modified radical mastectomy. Exact pathophysiology and risk factors for seroma is still a matter of debate. This prospective cross-sectional study aims to detect incidence of seroma formation in patients undergoing Modified Radical Mastectomy (MRM) in carcinoma breast and to identify risk factors for seroma in MRM patients. MATERIALS AND METHODS All patients who underwent modified radical mastectomy for carcinoma breast over a period of 1 year were enrolled and prospectively followed up. Patients were assessed for parameters including age, BMI, diabetes, hypertension, serum haemoglobin levels, neoadjuvant chemotherapy and T-stage in preoperative period. Level of lymph node dissection and type of drainage used were also assessed. Drain volumes in each postoperative day was documented and mean volumes calculated. Clinically detectable seroma, if present, was diagnosed 14 days after removal of drain. RESULTS Out of the 118 patients studied, incidence of seroma was found to be in 22.88%. Incidence of seroma was found to be higher in patients with BMI >25. It was also significantly higher in patients with first day drain volume more than 150 mL. No statistically significant difference in incidence was noted with age, diabetes, hypertension, serum haemoglobin levels, neoadjuvant chemotherapy, T-stage of disease or level of lymph node dissection. CONCLUSION Incidence of seroma is higher in patients with BMI >25. Occurrence of seroma can be predicted even on the first postoperative day, if the drain volume is more than 150 mL.