Assessment of risk factors and prevalence of complications following mastectomy and related axillary procedures

Introduction: Mastectomy is a common surgical intervention for breast carcinoma but is often associated with complications impacting patients’ recovery and quality of life. The aim of the study was to determine the risk factors and the prevalence of complications following mastectomy and related axillary procedures among a selected group of patients in the National Hospital Galle.
Methods: A descriptive, cross-sectional study was carried out among 390 patients selected using convenient sampling method. The data were obtained from the medical records of the patients who underwent mastectomy and related axillary procedures from June 2022 to June 2024. Risk factors and prevalence of complications were evaluated using standard statistical tests.
Results: The most common complication was axillary paraesthesia (25.4%), while chronic pain syndrome was the least frequent (1.8%). Obesity, age >65 years, diabetes, and recurrence episodes were significant risk factors for complications. Surgical site infections were strongly associated with obesity [Odds Ratio (OR)=25.3], age >65 years (OR=6.86), and recurrence (OR=21.2). Seroma formation was associated diabetes (OR=4.43), obesity (OR=6.8), age >65 years (OR=6.60), and tumour recurrence (OR=2.63). Flap necrosis and lymphoedema were more common in patients with advanced age, diabetes, obesity, or recurrence (p<0.05 in all). Venous thromboembolism was associated with age >65 years (OR=7.09), diabetes (OR=6.43), hypertension (OR=7.02), and obesity (OR=13.14). Age >65 years was the primary risk factor for most complications, while gender and bronchial asthma had no effect.
Conclusions and recommendations: Heightened monitoring of older, obese, and chronically ill patients is crucial to reduce post-operative complications. 
Comprehensive evaluations and tailored surgical and post-operative care for high-risk groups are recommended to improve outcomes.