Analysis of Related Factors and Preventive Measures for Major Complications in Modified Radical Mastectomy for Breast Cancer

Abstract

Objective: To analyze the incidence of common complications after modified radical mastectomy, identify relevant risk factors, and evaluate potential intervention points from the perspective of perioperative holistic management, providing a reference for complication prevention. Methods: A retrospective study design was employed, selecting 200 patients who underwent modified radical mastectomy for breast cancer from January 2021 to June 2025. Based on whether postoperative complications occurred, patient demographics, tumor characteristics, surgical details, and postoperative management were collected. Univariate analysis was used to screen potentially relevant variables, followed by multivariate logistic regression models to identify independent risk factors for each major complication type.Results: Among all patients, 85 cases (42.5%) developed at least one major complication. Among the cases, 15 patients presented with multiple complications, with subcutaneous effusion being the most common (19.0%), followed by upper limb lymphedema (11.0%) and flap necrosis (9.0%). The incidence of incision infection, scar contracture, and postoperative hemorrhage was relatively low. Multivariate analysis revealed that high BMI and excessive daily drainage volume (>20 mL) during postoperative tube removal were independent risk factors for subcutaneous effusion; high BMI, history of diabetes, and axillary lymph node dissection grade III were independent risk factors for upper limb lymphedema; smoking history was an independent risk factor for flap necrosis; and delayed initiation of postoperative functional exercises was an independent risk factor for scar contracture. Conclusion: Modified radical mastectomy for breast cancer is associated with a wide range of common complications. High BMI (≥25 kg/m²), comorbid diabetes, smoking history, axillary lymph node dissection extent reaching grade III, daily drainage volume>20 mL during tube removal, and delayed initiation of postoperative systematic functional exercises (>14 days) are independent risk factors for major postoperative complications. However, most risks can be controlled through perioperative management strategies. Preoperative risk assessment based on individual patient characteristics, meticulous intraoperative techniques, enhanced drainage management, and early functional exercises postoperatively can help reduce complication incidence.