Skip to content
DraconiticResearch
Search Sources API
201,818 studies31 sourcesUpdated 24 min ago
Peer-reviewedCC BY 4.0Frontiers in Oncology

Association of drainage volume decline trajectories during the first 7 postoperative days with persistent seroma on postoperative day 30 after modified radical mastectomy for breast cancer

  • Qingzhao Bian1
  • Xiangyu Wu1
  • Mingkun Cui1
  1. 1Department of Thyroid and Breast Surgery I, Cangzhou Central Hospital
Open at sourcePDFDOICite

Abstract

Background: Persistent seroma after modified radical mastectomy (MRM) with axillary lymph node dissection (ALND) can prolong drainage and recovery. We identified drainage trajectories during the first postoperative week and evaluated their association with persistent seroma on postoperative day 30.

Methods: This single-center retrospective study included 306 adults with unilateral invasive breast cancer who underwent MRM with level I–II ALND between 2021 and 2024. Trajectories of daily combined drainage volume were identified using latent class mixed-effects models. Firth penalized-likelihood logistic regression was used to adjust for age, body mass index, diabetes mellitus, neoadjuvant systemic therapy, resected specimen weight, operative time, and the number of dissected lymph nodes. Sensitivity analyses addressed uncertainty in class assignment, outcome definition, retention of the original drain, pathologic T category, and operating surgeon. Exploratory complete-case models compared trajectory classification with simpler drainage measures.

Results: Rapid-decline (123 patients), moderate-decline (127 patients), and persistently high-output (56 patients) trajectories were identified. Persistent seroma occurred in 7.3%, 19.7%, and 57.1% of patients, respectively ( P < 0.001). Relative to the rapid-decline trajectory, the adjusted odds ratios were 2.58 [95% confidence interval (CI), 1.10–6.07] and 11.44 (95% CI, 3.92–33.37), respectively. The association for the persistently high-output trajectory remained strong across sensitivity analyses, whereas that for the moderate-decline trajectory was less stable. The trajectory and postoperative day 7 (D7) drainage models showed similar discrimination. Adding trajectory class provided little incremental information beyond D7 drainage but improved model fit and discrimination beyond 7-day cumulative drainage and the relative decline from postoperative day 1 (D1) to D7.

Conclusions: Persistently high output was consistently associated with persistent seroma on postoperative day 30. Trajectory classification should remain a research-oriented postoperative risk-stratification variable. The incremental clinical value of trajectory classification over the simpler D7 drainage measurement remains uncertain and requires prospective validation. Clinical application requires multicenter external validation, assessment of class-assignment reproducibility, calibration, clinically meaningful thresholds, and evaluation of clinical utility.

Related

  1. A less invasive alternative to fenestration for selected localized postoperative empyema with persistent air leak: prolonged open drainage using a large-sized cut tube in two patients.
    Hidetoshi Inoue, Nobuhiro Izumi, Kazuya Kishimoto +6
    General thoracic and cardiovascular surgery casesPeer-reviewedCC BY-NC-NDFull textGeneral medicineEurope PMC
  2. Development and internal validation of a machine learning prediction model for postoperative hemorrhage following modified radical mastectomy for breast cancer
    Weiyuan Chen, Xiaoxu Li, Xiaoman Zhang +1
    Gland SurgeryPeer-reviewedCC BY-NC-NDFull textGeneral medicineEurope PMC
  3. Single Versus Double Drainage After Modified Radical Mastectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
    Ahmed Abu-Zaid, Yara S. Alseddiqi, Mohammad M. Sarkhouh +11
    Journal of Clinical MedicinePeer-reviewedCC BY 4.0OncologyCrossref
  4. Ludwig Angina at 28 Weeks’ Gestation in Somalia with Persistent Deep Neck Collections Requiring Repeat Surgical Drainage: A Case Report
    Ismail Mohamed Abdulle, Rayan Abdirahman Hassan
    Infection and Drug ResistancePeer-reviewedCC BY-NC 4.0Full textInfectious diseasePMC
  5. Analysis of Factors Influencing Postoperative Drainage Following Reduction Mammoplasty.
    Yuan Qin, Xingmin Hu, Xin Li +2
    Nursing openPeer-reviewedCC BY-NC-NDFull textSurgery & anaesthesiaEurope PMCDOAJ

Cite

BibTeXRIS
BibTeX
@article{bian2026association,
  title = {{Association of drainage volume decline trajectories during the first 7 postoperative days with persistent seroma on postoperative day 30 after modified radical mastectomy for breast cancer}},
  author = {Qingzhao Bian and Xiangyu Wu and Mingkun Cui},
  journal = {Frontiers in Oncology},
  year = {2026},
  month = oct,
  doi = {10.3389/fonc.2026.1981532},
  url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1981532/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Association of drainage volume decline trajectories during the first 7 postoperative days with persistent seroma on postoperative day 30 after modified radical mastectomy for breast cancer
AU  - Qingzhao Bian
AU  - Xiangyu Wu
AU  - Mingkun Cui
PY  - 2026
DA  - 2026/10/28
JO  - Frontiers in Oncology
DO  - 10.3389/fonc.2026.1981532
UR  - https://www.frontiersin.org/articles/10.3389/fonc.2026.1981532/full
AB  - Background: Persistent seroma after modified radical mastectomy (MRM) with axillary lymph node dissection (ALND) can prolong drainage and recovery. We identified drainage trajectories during the first postoperative week and evaluated their association with persistent seroma on postoperative day 30.  Methods: This single-center retrospective study included 306 adults with unilateral invasive breast cancer who underwent MRM with level I–II ALND between 2021 and 2024. Trajectories of daily combined drainage volume were identified using latent class mixed-effects models. Firth penalized-likelihood logistic regression was used to adjust for age, body mass index, diabetes mellitus, neoadjuvant systemic therapy, resected specimen weight, operative time, and the number of dissected lymph nodes. Sensitivity analyses addressed uncertainty in class assignment, outcome definition, retention of the original drain, pathologic T category, and operating surgeon. Exploratory complete-case models compared trajectory classification with simpler drainage measures.  Results: Rapid-decline (123 patients), moderate-decline (127 patients), and persistently high-output (56 patients) trajectories were identified. Persistent seroma occurred in 7.3%, 19.7%, and 57.1% of patients, respectively ( P < 0.001). Relative to the rapid-decline trajectory, the adjusted odds ratios were 2.58 [95% confidence interval (CI), 1.10–6.07] and 11.44 (95% CI, 3.92–33.37), respectively. The association for the persistently high-output trajectory remained strong across sensitivity analyses, whereas that for the moderate-decline trajectory was less stable. The trajectory and postoperative day 7 (D7) drainage models showed similar discrimination. Adding trajectory class provided little incremental information beyond D7 drainage but improved model fit and discrimination beyond 7-day cumulative drainage and the relative decline from postoperative day 1 (D1) to D7.  Conclusions: Persistently high output was consistently associated with persistent seroma on postoperative day 30. Trajectory classification should remain a research-oriented postoperative risk-stratification variable. The incremental clinical value of trajectory classification over the simpler D7 drainage measurement remains uncertain and requires prospective validation. Clinical application requires multicenter external validation, assessment of class-assignment reproducibility, calibration, clinically meaningful thresholds, and evaluation of clinical utility.
SN  - 2234-943X
ER  -