Factors predicting seroma formation after mastectomy for Chinese breast cancer patients.
BACKGROUND
Seroma formation after mastectomy typically delays recovery and adds to morbidity.


OBJECTIVE
This retrospective review was undertaken to identify factors which predict development of seroma after mastectomy for breast cancer patients.


METHODS
119 consecutive patients intended for mastectomy for the treatment of primary breast cancer were included. Factors taken into consideration were epidemiological, peri-operative in nature and those related to wound drainage output.


METHODS
Total mastectomy was performed and axillary sampling was taken. All patients were reviewed within two weeks after leaving hospital, unless seroma formation was detected before discharge. The diagnosis of seroma was made clinically when a collection was detected beneath the skin flaps.


METHODS
Student's t test was used with continuous variables and the X2 test for categorical situations. Fisher's exact test was applied when small numbers were encountered. A two-tailed test of P< 0.05 was considered significant. Univariate analyses were performed.


RESULTS
The incidence of seroma formation was eight per cent. Five factors were identified to be significantly related to seroma formation: i) age over 45 years; ii) hypertension; iii) total drainage output exceeding 500 ml in the first three postoperative days; iv) drainage for more than eight days. Immediate breast reconstruction prevents the formation of seroma.


CONCLUSIONS
The presence of hypertension in a patient over 45 years should alert the surgeon to possible seroma formation, particularly when the post-operative drainage exceeded 500 ml in the first three days. Appropriate preventive measures should then be implemented.
Loo
Wings Ty
WT
Comprehensive Centre For Breast Diseases, UNIMED Medical Institute, 10/F, Luk Kwok Centre, 72 Gloucester Road, Wanchai, Hong Kong.
Chow
Louis Wc
LW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008408:Mastectomy / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D049291:Seroma / Q000209:etiology* / Q000628:therapy