Comparison of early postoperative outcomes for breast conservative surgery and modified radical mastectomy in breast cancer in a tertiary hospital: A prospective observational study

Abstract

Breast cancer is the most common malignant tumour in women in the world, with an incidence of 13.5% in India. For patients diagnosed with breast cancer, surgical options include breast conserving therapy (BCT) or modified radical mastectomy (MRM). This study aims to compare early post-operative complications in carcinoma breast patients undergoing MRM vs BCS at a tertiary care center in India. Patients undergoing BCS and MRM for carcinoma breast were prospectively studied over an 18-month period and postoperatively followed up for 3 months. Incidence of early post-operative complications such as seroma, flap necrosis, wound dehiscence and quality of life (QOL) were compared between the two groups. 106 patients were included in this study, of which 75 underwent MRM and 31 underwent BCS. There was no significant difference noted between these two groups with respect to the following; seroma formation (16.1% BCS vs. 13.3% MRM; p value =0.710), flap necrosis (3.2% vs. 2.7%; p value =0.87), wound dehiscence (3.2% vs. 5.3%; p value =0.63), wound infection (6.5% vs. 5.3% p value =0.823), average number of days of lymphorrhoea (15 ±9.76 vs. 15.7 ±7.49) and QOL post-surgery. Comparison of cost (> Rs.50,000) showed that expense of surgical treatment was significantly higher in MRM (24.0%) compared to BCS (9.7%). Early postoperative complications seen in BCS and MRM are comparable, with the most common early complication being seroma and lymphorroea. Patients should be educated regarding breast conservative surgery, its comparable results with MRM and social and physical impact irrespective of age and menstrual status.