Research Article

The effect of Modified Radical Mastectomy (MRM) with and without latissimus dorsi flap on seroma of Locally Advanced Breast Cancer (LABC) in Sanglah Hospital

Anak Agung Chris Tedy Pramana , I Ketut Widiana, I Gde Raka Widiana

Anak Agung Chris Tedy Pramana
Department of General Surgery, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia. Email: Tedy.zion@gmail.com

I Ketut Widiana
Department of Surgical Oncology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia

I Gde Raka Widiana
Department of Internal Medicine, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia
Online First: August 10, 2021 | Cite this Article
Pramana, A., Widiana, I., Widiana, I. 2021. The effect of Modified Radical Mastectomy (MRM) with and without latissimus dorsi flap on seroma of Locally Advanced Breast Cancer (LABC) in Sanglah Hospital. Intisari Sains Medis 12(2): 572-575. DOI:10.15562/ism.v12i2.1059


Background: Locally Advanced Breast Cancer (LABC) is defined as breast cancer spread locoregionally and without any signs of metastasis. Stage IIIA breast cancer is one type of LABC that can be removed surgically, and Modified Radical Mastectomy (MRM) remains the first surgical option. Seroma production is one of the most common complications post MRM, with the hypothesis stating that the Latissimus Dorsi (LD) flap technique is responsible for resulting in higher seroma output. This study aims to compare seroma production in LABC patients post MRM with and without LD flap.

Methods: This prospective cohort study was conducted in Sanglah General Hospital, Denpasar, between November 2018 and January 2020. The study sample was divided into 2 groups: LABC patients post MRM with and without LD flap reconstruction. Seroma was measured in milliliters (ml) and collected from the first to fifth day post-operation. Data were analyzed using SPSS version 21 for Windows.

Results: Forty LABC patients were enrolled in this study. The mean age for the group without latissimus dorsi flap was 48.45±7.01 years and 49.40±10.77 years for the group with latissimus dorsi flap. The mean seroma production in LABC patients who underwent MRM without and with LD flap reconstruction was 696.45±66.37 ml and 490.10±62.11 ml. There was a significant difference in the total of seroma between the treatment group without-LD flap and compared to with-LD flap reconstruction (p<0.001).

Conclusion: Seroma production is significantly higher in LABC patients post MRM without LD flap reconstruction than LABC patients with LD flap.

References

Simos D, Clemons M, Ginsburg OM, Jacobs C. Definition and consequences of locally advanced breast cancer. Curr Opin Support Palliat Care. 2014;8(1):33-38.

Spitale A, Mazzola P, Soldini D, Mazzucchelli L, Bordoni A. Breast cancer classification according to immunohistochemical markers: clinicopathologic features and short-term survival analysis in a population-based study from the South of Switzerland. Ann Oncol. 2009;20(4):628-635.

Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 2010;17(6):1471-1474.

Ribeiro GH, Kerr LM, Haikel RL, Peres SV, Matthes AG, Depieri Michelli RA, et al. Modified radical mastectomy: a pilot clinical trial comparing the use of conventional electric scalpel and harmonic scalpel. Int J Surg. 2013;11(6):496-500.

Vitug AF, Newman LA. Complications in breast surgery. Surg Clin North Am. 2007;87(2):431-451.

Ebner F, Friedl TWP, de Gregorio A, Lato K, Bekes I, Janni W, et al. Seroma in breast surgery: all the surgeons fault? Arch Gynecol Obstet. 2018;298(5):951-959.

Burgic M, Bruant Rodier C, Wilk A, Bodin F, Rifatbegovi? A, Halilbasic E, et al. Complications following autologous latissimus flap breast reconstruction. Bosn J Basic Med Sci. 2010;10(1):65-7.

Kuroi K, Shimozuma K, Taguchi T, Imai H, Yamashiro H, Ohsumi S, et al. Evidence-based risk factors for seroma formation in breast surgery. Jpn J Clin Oncol. 2006;36(4):197-206.

Duymaz T, ?yigün ZE, ?lgün AS, Ordu Ç, Üçüncü M, Alço G, et al. The Effect of Mini-Latissimus Dorsi Flap (MLDF) Reconstruction on Shoulder Function in Breast Cancer Patients. Eur J Breast Health. 2019;15(3):158-162.

Millikan RC, Newman B, Tse CK, Moorman PG, Conway K, Dressler LG, et al. Epidemiology of basal-like breast cancer. Breast Cancer Res Treat. 2008;109(1):123-39.

Ibraheem MH, Mina MG, Youssef YA, Boutrus R, Farouk A, Morsi A. The use of latissimus dorsi mini-flap in partial breast reconstruction. J Cancer Sci Clin Ther. 2019;3(4):240-250.

Quaresma M, Coleman MP, Rachet B. 40-year trends in an index of survival for all cancers combined and survival adjusted for age and sex for each cancer in England and Wales, 1971-2011: a population-based study. Lancet. 2015;385(9974):1206-1218.

Kokosis G, Khavanin N, Nahabedian MY. Latissimus Dorsi Musculocutaneous Flap for Complex Breast Reconstruction: Indications, Outcomes and a Proposed Algorithm. Plast Reconstr Surg Glob Open. 2019;7(8):e2382.

Gonzalez EA, Saltzstein EC, Riedner CS, Nelson BK. Seroma formation following breast cancer surgery. Breast J. 2003;9(5):385-388.

Houvenaeghel G, Bannier M, Rua S, Barrou J, Heinemann M, Lambaudie E, et al. Skin sparing mastectomy and robotic latissimus dorsi-flap reconstruction through a single incision. World J Surg Oncol. 2019;17(1):176.

Sampathraju S, Rodrigues G. Seroma formation after mastectomy: pathogenesis and prevention. Indian J Surg Oncol. 2010;1(4):328-333.

Lee JS, Jeon HJ, Lee J, Park HY, Yang JD. Treatment of late solidified hematoma in back donor site after breast reconstruction with latissimus dorsi flap: report of three cases. BMC Surg. 2019;19(1):51.


No Supplementary Material available for this article.
Article Views      : 168
PDF Downloads : 91