ADVANCES IN BREAST CANCER DIAGNOSIS AND TREATMENT: ESSENTIALS

Advances in breast cancer diagnosis and treatment Essentials_kapak

MANAGEMENT OF POSTOPERATIVE COMPLICATIONS OF BREAST SURGERY

Adile Dikmen1 Semih Öztürk2

1Medical Park Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara, Türkiye
2Medical Park Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara, Türkiye

Dikmen A, Öztürk S. Management of Postoperative Complications of Breast Surgery. In: Citgez B editor. Advances in Breast Cancer Diagnosis and Treatment Essentials. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.221-230.

ABSTRACT

Breast cancer is one of the most prevalent malignancies among women globally, and surgical intervention remains a fundamental component of its multidisciplinary treatment. Despite significant advancements in oncologic therapies, surgical techniques, and perioperative care, postoperative complications following breast cancer surgery continue to present substantial clinical and reconstructive challenges. These complications not only affect oncologic safety and wound healing but also have a direct impact on cosmetic outcomes and patients’ quality of life. This chapter provides a comprehensive and clinically oriented overview of postoperative complications associated with reconstructive breast surgery. Early complications-including hematoma, seroma, surgical site infection, skin flap necrosis, and wound dehiscence-are described in detail, with discussion of their incidence, risk factors, diagnostic criteria, and evidence-based management. The role of surgical technique, intraoperative decision-making, and perioperative patient care in reducing these complications is also addressed. Special attention is given to skin flap viability in nipple-sparing mastectomy and the use of intraoperative imaging technologies, such as indocyanine green (ICG) fluorescence angiography, to assess perfusion and reduce ischemic complications. Late complications, which often require long-term follow-up and secondary interventions, include lymphedema, chronic neuropathic pain syndromes (e.g., postmastectomy pain syndrome), aesthetic deformities, and complications associated with reconstruction-such as capsular contracture, implant exposure, fat necrosis, and partial or total flap failure. These issues are discussed in the context of both implant-based and autologous breast reconstruction techniques. The influence of adjuvant therapies, particularly radiotherapy and chemotherapy, on wound healing and reconstructive outcomes is also explored, as these treatments can significantly increase the risk and severity of complications. Throughout the chapter, emphasis is placed on preventative strategies and the importance of individualized patient selection and counseling. Optimizing outcomes requires a multidisciplinary approach that involves oncologic, surgical, and rehabilitative teams working in coordination. This chapter aims to serve as a practical and evidence-based resource to support surgeons in recognizing, preventing, and managing complications in breast cancer surgery, thereby improving functional, oncological, and aesthetic outcomes in affected patients.

Keywords: Breast cancer; Mastectomy; Breast reconstruction; Postoperative complications; Skin flap necrosis; Capsular contracture; Lymphedema; Postmastectomy pain

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