Abstract
Breast cancer is one of the most common malignancies in women. In many cases, a major component of complex treatment for breast cancer is surgery - radical mastectomy or radical breast resection. The aim of the work – to investigate the frequency and structure of complications after radical surgery with dissection of axillary lymph nodes in breast cancer patients. Material and methods. The baseline and surgical results of 147 women with breast cancer who underwent radical mastectomy or radical breast resection with lymph node dissection were analysed. Results. Complications in the early period after surgery for breast cancer were found in 76 (51.7 %), including postoperative extremity edema in 60 (40.8 %); lymphorrhea – in 37 (25.2 %), seroma – in 33 (22.4 %); wound infection in 18 (12.2 %), necrosis of the wound edges – in 15 (10.2 %) patients. Correlation of postoperative edema with almost all other complications was found, lymphorrhea and seroma were most associated with swelling and with each other; necrosis of edges with postoperative edema. Wound infection was significantly associated with lymphorrhea. Patients' age, stage of disease, and immunohistochemical type of tumour did not affect the development of complications. With increasing BMI, the incidence of complications increased significantly (χ2=9.530; p=0.009). The tendency to decrease the frequency of complications during reconstructive surgery was revealed (42.6 % versus 58.1 %, p=0.064), and adjuvant radiotherapy, on the contrary, contributed to the increase of complications (57.8 % versus 43.8 %, p=0.090). Conclusion. Radical operations with lymph node dissection in patients with breast cancer are characterized by a high frequency of early postoperative complications, mainly associated with disorders of lymphatic outflow, which indicates the need for a set of measures of preoperative preparation, improvement of surgical technique.
Highlights
Breast cancer is one of the most common malignancies in women [1, 2]
In addition to extensive tissue removal of the mammary gland, radical surgery is facilitated by lymph node dissection (LND) in the areas of potential metastasis, which leads to damage to the elements of lymphatic outflow and is one of the leading causes of complications of early and late postoperative period [4, 5]
It was revealed strong correlation of postoperative edema with almost all other complications, first of all, with the manifestations of lympho-venous outflow disorders: lymphorrhea; seroma. Significantly, this complication was correlated with the development of wound necrosis
Summary
Breast cancer is one of the most common malignancies in women [1, 2]. In many cases, a major component of complex treatment for breast cancer is surgery – radical mastectomy (RME) or radical breast resection (RBR) [3]. In the early period after surgery, the most common complications are the formation of lymphocele (seroma), lymphorrhea, postoperative edema, wound infections and impaired wound healing [6, 7], whose frequency increases during reconstructive operations especially using autoplastic methods [8]. The most common complication is seroma, the frequency of which reaches 85 %. Their development is associated both with the features of surgical interventions, and with the individual characteristics of patients [9]. No less relevant are wound complications, which worsen the cosmetic results of the operation, and increase the cost of treatment [10]
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