Guidelines for Complications of Cancer Treatment Vol VIII Part B

mastectomy for breast cancer. Early postoperativephysiotherapy is a common treatment to avoid shoulderdysfunction. The aim of this study was to evaluate if thefrequency of postoperative seromas could be reduced, withoutincreasing shoulder dysfunction, by delayed postoperativeshoulder exercises. METHODS: In a prospective study 163patients with breast cancer undergoing modified radicalmastectomy were randomized to physiotherapy starting onpostoperative day 1 or day 7. Patients were seen by thesurgeons and the physiotherapists during hospital stay and inthe outpatient department. Seromas and other complicationswere registered by the surgeons. The physiotherapistsinstructed the patients pre- and postoperatively and assessedshoulder function. RESULTS: There was a significantly higherincidence of postoperative seromas in the group of patientsthat started physiotherapy postoperative day 1 (38%)compared to the group that started physiotherapy postoperativeday 7 (22%) (p < 0.05). There was no significant differencebetween the groups in the late outcome of shoulder function.CONCLUSION: The incidence of seromas after modifiedradical mastectomy for breast cancer is reduced by delayingshoulder exercises one week postoperatively. Earlierpostoperative physiotherapy is not necessary to avoid impairedshoulder function.PMID: 9181227 [PubMed - indexed for MEDLINE]21. Electrocautery as a factor in seroma formationfollowing mastectomy.Porter KA, O’Connor S,Rimm E, et al. Am J Surg 1998Jul;176(1):8-11.BACKGROUND: Electrocautery has been postulated as afactor in the risk of seroma formation after mastectomy.METHODS: Eighty consecutive mastectomies in 74 patientswere randomly assigned to dissection of the mastectomy flaps28