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Abstract
POSTOPERATIVE COMPLICATIONS FOLLOWING MODIFIED RADICAL MASTECTOMY
Dr. Qusay Ahmed Njati Younus*
ABSTRACT
Background: Modified radical mastectomy remains one of the most commonly performed surgical procedures for the management of breast cancer, particularly in patients with locally advanced disease. Despite advances in surgical techniques and perioperative care, postoperative complications continue to contribute significantly to patient morbidity and may adversely affect recovery and subsequent oncological treatment. Objectives: To evaluate the frequency and pattern of postoperative complications following modified radical mastectomy and to identify factors associated with their occurrence among patients treated at Al Salam Teaching Hospital, Mosul. Methods: A retrospective cross-sectional study was conducted at Al Salam Teaching Hospital, Mosul, Iraq, between September 2024 and April 2026. A total of 112 female patients who underwent modified radical mastectomy for histopathologically confirmed breast cancer were included. Demographic, clinical, pathological, and operative data were collected from hospital records. Postoperative complications assessed included seroma formation, surgical site infection, hematoma, wound dehiscence, flap necrosis, lymphedema, readmission, and reoperation. Statistical analysis was performed using SPSS version 27. Continuous variables were expressed as mean ± standard deviation, while categorical variables were presented as frequencies and percentages. A P value of less than 0.05 was considered statistically significant. Results: The mean age of the patients was 52.6 ± 11.4 years. Invasive ductal carcinoma was the most common histopathological subtype, accounting for 83.0% of cases. Overall postoperative complications occurred in 47 patients (42.0%). Seroma formation was the most frequent complication, occurring in 25.0% of patients, followed by surgical site infection (11.6%), lymphedema (8.9%), wound dehiscence (7.1%), hematoma (4.5%), and flap necrosis (3.6%). Postoperative complications were significantly more common among diabetic patients (P = 0.004) and obese patients (P = 0.009). Multivariate logistic regression analysis identified diabetes mellitus (OR = 2.84, 95% CI: 1.27–6.38, P = 0.011) and obesity (OR = 2.41, 95% CI: 1.12–5.21, P = 0.024) as independent predictors of postoperative complications. Conclusions: Postoperative complications following modified radical mastectomy remain relatively common, with seroma formation representing the most frequent complication. Diabetes mellitus and obesity were identified as significant independent predictors of postoperative morbidity. Careful perioperative assessment, optimization of comorbid conditions, and meticulous surgical management may contribute to reducing complication rates and improving postoperative outcomes.
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