Risk Factors for Seroma Development Following Breast Cancer Surgery

Abstract

Background and Objective: Seroma formation is a common complication after modified radical
mastectomy and breast conservation surgery in breast cancer patients. This study investigates the factors
influencing seroma development in women undergoing breast cancer surgery at a tertiary care hospital in
Lahore, Pakistan.
Methods: Aretrospective analysis was conducted at a tertiary care hospital in Lahore, including 159 female
breast cancer patients aged 20 years and above from 01 august 2020 to 30 September 2022. Patients who
underwent modified radical mastectomy (MRM) or breast conservation surgery were included, while those
with uncontrolled diabetes, advanced liver disease, or prior axillary surgery were excluded. Data were
collected using a semi-structured questionnaire, covering socio-demographic characteristics, known risk
factors, and disease history and was analyzed using SPSS-26.
Results: Seroma formation was observed in 37(23.27%) patients out of 159 total patients .On bivariate
analysis the findings revealed a higher incidence of seroma among patients from urban areas as compared to
rural (29.9% vs 12.9%, p=0.013) and higher in lower socioeconomic backgrounds (> 32% Vs 19.2%,
p=0.042). High body mass index (p=0.015) was also associated with increased seroma formation with more
in higher BMI as compared to normal BMI ( 29% Vs 11.5%, p = 0.015). Surgical factors, like the number of
axillary lymph nodes involved p=0.032) and postoperative wound infections (p<0.001) were also
significantly associated with seroma formation. However, on multivariate analysis only body mass index
with over weight patients (AOR= 4.89, 95% CI=1.29-8.79) , axillary lymph nodes
involvement(AOR=2.88,95% CI=1.18-7.05) and post operative infection (AOR=6.23, 95% CI=2.54-15.28)
showed significant association. However, factors such as age, education, neoadjuvant chemotherapy,
diabetes, hypertension, and postoperative radiation showed no significant association with seroma
formation.
Conclusion: Our study found a higher rate of seroma formation, with possible predictors including body
mass index, extent of axillary nodal clearance and post operative infection. Mitigation of these factors can
prevent seroma formation and better recovery of patient.