Complications following mastectomy
Axel Löfgren, Fredrik Wärnberg, Jenny HeimanAbstract
Introduction
It is reported that mastectomy has more surgical site complications (SSC) compared to breast conserving surgery. Complications includes infection, seroma, hematoma, and wound dehiscence. The aim was to detail baseline characteristics and rate of complications in patients undergoing mastectomy at our hospital.
Methods
This retrospective cohort included 251 consecutive women who underwent mastectomy at Sahlgrenska University Hospital during 2021. SSC within 90 days of surgery were registered according to the Clavien–Dindo classification system. Patients undergoing direct reconstruction were excluded.
Results
The cohort had a mean age of 64.8 years, mean BMI 27.2 kg/m2. The mean operative time was 102 min. Other baseline data were smoking (7.2%), diabetes (10.8%), neoadjuvant chemotherapy (16.3%). Invasive carcinoma was the most common histopathological diagnosis (90.4%) followed by in situ carcinoma (5.2%). Overall, 45.4% of all patients were classified as having at least one complication, the most common was seroma (41.8%). Reoperation were required in 5.2% of cases and the most common cause of reoperation was hematoma. According to the Clavien–Dindo classification, 54.6% of patients experienced no postoperative complications. Minor complications (Grade I–II) occurred in 39.9% of patients, while major complications (Grade III) were observed in 5.6%. No life thretening complications were observed.
Discussion
Seroma and other complications following mastectomy are common, and these results are consistent with other studies. These findings highlight the need for strategies to reduce postoperative complications, of which one could be incisional negative pressure wound therapy (iNPWT). iNPWT will be evaluated in a prospective study.