Complications of mastectomy for breast cancer in a tertiary care centre in South-west Nigeria
Keywords:Breast cancer, Chemotherapy, Haemorrhage, Mastectomy, Post-operative complications
Background: An important aspect of the surgical management of breast cancer is loco-regional control which can be accomplished by either breast conservation surgery or mastectomy.
Objective: To examine the outcome of the operation of mastectomy with respect to the complications of the procedure.
Methods: This is a retrospective study of all the patients who had a mastectomy for breast cancer in a Nigerian tertiary care centre from 1st January 2012 to March 2019. The hospital records of the patients were retrieved. Demographic and relevant clinical characteristics of the patients were extracted.
Results: A total of 77 cases were eligible, 76 women and one man. The age range was 28-76 years. Right mastectomy was performed in 54.5% cases. Preoperative comorbiditiesincludedobesity(34%), hypertension (31.2%), anaemia (6.5%) and Diabetes mellitus (7.8%). Modified radical mastectomy was done in 51.9% cases, simple mastectomy in 36.4%, “Toilet Mastectomy”in 9.1%, and mastectomy after breast conservation treatment in 2%. Twenty-eight percent of the cases required a blood transfusion, 31.2% received neoadjuvant chemotherapy while 58.2% had adjuvant therapy. The complications observed included: haemorrhage (7.8%), seroma (9.1%), flap necrosis (9.1%) andtumourrecurrence (7.8%). As at the time of the report, 41.6 % were alive, 19.4% were dead and 39.0% were lost to follow-up.
Conclusion:The complications of mastectomy were mostly haemorrhage, seroma,and flap necrosis, similar to previous reports from other parts of the world.
El Saghir NS, Adebamowo CA, Anderson BO, Carlson RW, Bird PA, Corbex M. Breast cancer management in low resource countries (LRCs): consensus statement for the Breast Global Health Initiative. Breast 2011; 20 (Suppl.2): S3-S11.
Ogundiran TO, Ayandipo OO, Ademola AF, Adebamowo CA. Mastectomy for management of breast cancer in Ibadan Nigeria. BMC Surg 2013; 13: 59. doi:10.1186/1471-2482-13-59.
Farquharson M, Hollingshead J, Moran B. Surgery of the Breast. In: Farquharson M, Hollingshead J, Moran B. (Editors) Farquharson’s Textbook of Operative General Surgery. 10th Edition. CRC Press. 2015: 31 -43.
El-Tamer MB, Marie Ward B, Schifftner T, Neumayer L, Khuri S, Henderson W. Morbidity and mortality following breast cancer surgery in women. National Benchmarks for Standards of Care. Ann Surg 2007; 245: 665-671.
N’guessan YI, DiaLamine J, Moctar T, Corneille ST, Gilbert TS, Adunfe OM. et al. Review of mastectomy in the Department of Gynaecology at The Treichville Teaching Hospital , Abidjan- Cote d’Ivoire. Int J Reprod Contracept Obstet Gynecol 2018; 7: 1313-1317.
Rostein C, Ferguson R, Cumming KM, Piedmonte MR, Lucey J, Banish A. Determinants of clean surgical wound infections for breast procedures at an oncology center. Infect Control Hosp Epidemiol. 1992 ; 13:207-214.
Pysz M. Blood transfusions in breast cancer patients undergoing mastectomy: possible importance of timing. J Surg Oncol 2000; 75: 258-263.
Akyol AM, Galloway DJ, George WD. Perioperative blood transfusion does not promote recurrence and death after mastectomy for breast cancer. Br J Surg1992; 78: 1358-1361.
Decker MR, Greenblatt DY, Havlena J, Wikie LG, Greenberg CC, Neuman HB. Impact of neoadjuvant chemotherapy on wound complication after breast surgery. Surg 2012; 152:382-388.
Bowen ME, Mone MC, Buys SS, Sheng X, Nelson EW. Surgical outcomes for mastectomy patients receiving neoadjuvant chemotherapy. A propensity- matched Analysis. Ann Surg 2017; 265: 448-456.
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.