Observational Study on the Incidence and Risk Factors for Seroma Formation Following Modified Radical Mastectomy

Abstract

Background: Seroma formation remains the most frequent postoperative complication following modified radical mastectomy (MRM) for breast cancer. It contributes significantly to patient discomfort, prolonged drainage duration, delayed wound healing, increased hospital visits, and higher healthcare costs. Despite advancements in surgical techniques, seroma continues to affect a substantial proportion of patients undergoing breast cancer surgery.
Objective: To determine the incidence of seroma formation following modified radical mastectomy and identify associated risk factors among patients treated at a tertiary care teaching hospital.
Methods: A prospective observational study was conducted among 50 patients undergoing modified radical mastectomy at Jawaharlal Nehru Medical College & Hospital, Bhagalpur, Bihar, India, from July 2024 to December 2025. Demographic, clinical, and surgical variables were recorded. Patients were followed for 30 days postoperatively for development of seroma. Statistical analysis was performed using SPSS version 26.0. Chi-square test, independent t-test, and logistic regression analysis were applied. A p-value <0.05 was considered statistically significant.
Results: The overall incidence of seroma formation was 34.0% (17/50). Seroma occurrence was significantly associated with obesity (p=0.012), diabetes mellitus (p=0.021), neoadjuvant chemotherapy (p=0.034), prolonged drainage duration (p=0.006), and high postoperative drain output (p=0.001). Multivariate analysis identified obesity (OR=3.84; 95% CI:1.22–12.11), diabetes mellitus (OR=3.12; 95% CI:1.01–9.65), and drain output >1000 mL (OR=4.57; 95% CI:1.43–14.58) as independent predictors of seroma formation.
Conclusion: Seroma remains a common complication following modified radical mastectomy. Obesity, diabetes mellitus, neoadjuvant chemotherapy, and increased postoperative drainage significantly increase the risk of seroma formation. Early identification of high-risk patients may facilitate implementation of preventive strategies and improve postoperative outcomes.