POSTOPERATIVE COMPLICATIONS PROGNOSIS OPTIMIZATION IN PATIENTS WITH BREAST CANCER
https://doi.org/10.35266/2949-3447-2025-2-7
Abstract
Breast cancer remains one of the widespread diseases in female population. Surgical method is the basic approach to cytoreduction at the early stage of disease diagnostics, ensuring the achievement of higher rates of distant relapse-free and overall survival. However, surgical complications remain an acute concern. Performing preserving surgeries with biopsy of the sentinel lymph node in the postoperative period can lead to the development of hematoma, seroma, infection, and flap necrosis. The developed method of breast resection with lymph node dissection significantly reduced early postoperative complications by 3.8% (against 27.6% with standard incision, p <0.05). Inflammatory infiltrate in the postoperative wound area occurred in 1.9% of patients (compared to 11.4% with the standard incision, p < 0.05), and seroma in the postoperative wound area occurred in 1.9% of patients (compared to 14.2% with the standard incision, p < 0.05). We successfully tested our proposed method for predicting early postoperative complications, and it showed prognostic value. The main predictor of the onset of wound complications was the index of microcirculation. Thermometry was an additional method. Thus, the use of Z-shaped incision for breast cancer preserving surgery, as well as the use of screening techniques, is important for prognosis optimization of early surgical complications.
About the Authors
S. A. Stolyarov
Medical University “Reaviz”, Samara
Russian Federation
Russian Federation
Doctor of Sciences (Medicine), Professor, Head of the Department of Surgical Diseases
L. A. Trusova
Medical University “Reaviz”, Samara
Russian Federation
Russian Federation
Assistant Professor, Oncologist
References
1. Sung H., Ferlay J., Siegel R. L. et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries // CA: A Cancer Journal for Clinicians. 2021. Vol. 71, no. 3. P. 209–249. https://doi.org/10.3322/caac.21660.
2. Lohani K. R., Kumar C., Kataria K. et al. Role of tranexamic acid in axillary lymph node dissection in breast cancer patients // The Breast Journal. 2020. Vol. 26, no. 7. P. 1316–1320. https://doi.org/10.1111/tbj.13810.
3. Ma H., Ursin G., Xu X. et al. Body mass index at age 18 years and recent body mass index in relation to risk of breast cancer overall and ER/PR/HER2-defined subtypes in white women and African-American women: A pooled analysis // Breast Cancer Research. 2018. Vol. 20. https://doi.org/10.1186/s13058-017-0931-5.
4. Krug E., Berg L., Lee C. et al. Evidence-based recommendations for the use of negative pressure wound therapy in traumatic wounds and reconstructive surgery: Steps towards an International Consensus // Injury. 2021. Vol. 42. P. 1–12. https://doi.org/10.1016/S0020-1383(11)00041-6.
5. Nischwitz S. P., Luze H., Kamolz L.-P. Thermal imaging via FLIR One – A promising tool in clinical burn care and research // Burns. 2020. Vol. 46, no. 4. P. 988–989. https://doi.org/10.1016/j.burns.2020.02.017.
6. Wearn C., Lee K. C., Hardwicke J. et al. Prospective comparative evaluation study of laser Doppler imaging and thermal imaging in the assessment of burn depth // Burns. 2018. Vol. 44, no. 1. P. 124–133. https://doi.org/10.1016/j.burns.2017.08.004.
7. Hardwicke J., Thomson R., Bamford A. et al. A pilot evaluation study of high resolution digital thermal imaging in the assessment of burn depth // Burns. 2013. Vol. 39, no. 1. P. 76–81. https://doi.org/10.1016/j.burns.2012.03.014.
8. Jaspers M. E. H., Maltha I., Klaessens J. H. G. M. et al. Insights into the use of thermography to assess burn wound healing potential: A reliable and valid technique when compared to laser Doppler imaging // Journal of Biomedical Optics. 2016. Vol. 21, no. 9. https://doi.org/10.1117/1.jbo.21.9.096006.
9. Lightner A. L., Fleshner P. R. Introducing the management of postoperative complications // Surgical Clinics of North America. 2021. Vol. 101, no. 5. P. xvii–xviii. https://doi.org/10.1016/j.suc.2021.07.002.
10. Федорович А. А. Микрососудистое русло кожи человека как объект исследования // Регионарное кровообращение и микроциркуляция. 2017. Т. 16, № 4. С. 11–26. https://doi.org/10.24884/1682-6655-2017-16- 4-11-26.
11. Secomb T. W., Pries A. R. The microcirculation: Physiology at the mesoscale // The Journal of Physiology. 2011. Vol. 589, no. 5. P. 1047–1052. https://doi.org/10.1113/jphysiol.2010.201541.
12. Рак молочной железы : клинические рекомендации. 2018. URL: https://oncology.ru/association/clinical-guidelines/2018/rak_molochnoy_zhelezy_pr2018.pdf (дата обращения: 05.04.2025).
Review
For citations:
Stolyarov S.A., Trusova L.A. POSTOPERATIVE COMPLICATIONS PROGNOSIS OPTIMIZATION IN PATIENTS WITH BREAST CANCER. Vestnik SurGU. Meditsina. 2025;18(2):52-59. (In Russ.) https://doi.org/10.35266/2949-3447-2025-2-7
Views:
42
Email this article 
