Modification of transverse skin incision: a successful idea for reducing seroma formation after mastectomy and axillary dissection for breast cancer

Purposes The aim of this study was to assess the importance of making the lateral part of transverse skin incision for mastectomy vertical along the anterior axillary fold, for decreasing postmastectomy seroma in breast cancer. Background Seroma after mastectomy represents annoying problem for the surgeon and the patient; it may delay adjuvant therapy and is also associated with prolonged recovery period and multiple physician visits. Moreover, it may lead to significant morbidity. Despite there are many methods for dealing with this seroma, it remains in question. Patients and methods The study included 100 female patients: 11 (11%) were below 40 years of age, 66 (66%) were between 40 and 50 years of age, and 23 (23%) were above 50 years of age. All patients underwent clinical evaluation, laboratory assessment, ultrasound and soft-tissue mammography examination, and tissue biopsy. All patients underwent modified radical mastectomy during which the patients were divided into two groups: group A with transverse skin incision crossing the anterior axillary fold and group B with modification of transverse skin incision (making its lateral part vertical along the anterior axillary fold). Postoperative follow-up was performed during the first 4 months. Results Decreased seroma formation was observed in group B with transverse skin incision with vertical lateral part along the anterior axillary fold to a great extent (P 0.01). Conclusion Transverse skin incision with vertical lateral part along the anterior axillary fold combats seroma formation, and hence this modification not only decreases morbidity and recovery period, but also allows early adjuvant therapy.