Predicting factors of Seroma formation after Breast cancer surgery

ABSTRACT

To determine the frequency of seroma formation, and the role of hypertension, diabetes mellitus, neoadjuvant chemotherapy and nodal dissection in the development of seroma after breast surgery. Hospital based prospective study with descriptive design [interventional descriptive] from April 2002 to March 2005. Setting: Department of General Surgery [Ward-2], Jinnah Postgraduate Medical Centre, Karachi. 160 patients of Carcinoma Breast who underwent elective surgery. Patients were divided into two groups viz. those who developed seroma [Group-A] and those who did not [Group-B]. The data was tabulated on SPSS version 10.0. Demographic data was represented in frequencies. The effect of various risk factors [hypertension, diabetes mellitus, nodal status, tumour histology] was calculated and presented as relative risk [RR]. Out of 160 patients, there were 157 females and three males, with a sex ratio of 53F1M. Their ages ranged from 23 to 100 years. A total of 144 patients underwent modified radical mastectomy and 16 breast conservation. Seroma formed in 28 [17.5%] cases. Out of 36 hypertensive patients 22 developed seroma [RR=12.72], while amongst the 28 diabetics two and amongst the 64 patients that received neoadjuvant chemotherapy 12 developed seroma. The total number of axillary lymph nodes in patients who developed seroma ranged from 4-28 as compared to non-seroma group with 4-30; an average of nine [0-25] positive nodes were seen in both the groups. Seroma formation is a common complication of the modified radical mastectomy. The only factor that appeared to contribute to seroma formation in this series was hypertension. Neoadjuvant chemotherapy marginally increased the risk, but diabetes had no role in seroma formation