ABSTRACT
Introduction: The most common complication developing after modified radical mastectomy (MRM) is seroma formation which is a significant cause of increased morbidity, a longer post-operative stay and increased the cost of treatment. Early recognition can lead to decreased patient morbidity and discomfort in such cases. Methods: This study was conducted at Gajra Raja Medical College and Jaya Arogya Group of Hospitals, Gwalior, Madhya Pradesh, India on 80 patients of carcinoma breast undergoing MRM during September 2013 to August 2014. Factors taken into the scope of study for finding association with seroma formation were: Age, body mass index (BMI), hemoglobin level, serum protein level, clinically palpable lymph nodes, size of primary tumor, modality used for dissection of flaps, flap fixation to muscle layer, method of skin closure, drainage volume on 1st post-operative day, days taken to reach drainage volume <30 ml, and post-operative days after which active physiotherapy of arm started. The statistical association was deduced using Chi-square and Student’s t-test. Results: The incidence of seroma in our study sample was found to be 22.5% (n = 18). The significant factors resulting is strongly increased likelihood of seroma formation were older age of patient, higher BMI, higher amount of drainage volume on the first post-operative day and longer duration taken to reach drainage volume <30 ml while factors that significantly showed association with decreased incidence were suture fixation of skin flap to underlying muscle layer and earlier initiation of arm physiotherapy postoperatively. Conclusion: Although the factors responsible for seroma formation after MRM remain not clearly identified and different studies showing variable results, factors such as older and obese patients, and a higher and prolonged output from drains should alert the surgeon to have a high index of suspicion for the development of seroma in post-operative period.