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Article Open Access

Reduction of seroma by pectoralis fascia dissection using an energy device in total mastectomy for breast cancer: An observational study 

  • Authors:
    • Hiroaki Shima
    • Yuta Kondo
    • Takashi Nakamura
    • Daisuke Kyuno
    • Noriko Nishikawa
    • Satoko Uno
    • Ai Noda
    • Kiminori Sato
    • Asaka Wada
    • Toru Mizuguchi
  • View Affiliations / Copyright

    Affiliations: Department of Surgery, Division of Breast Surgery, Sapporo Medical University, Sapporo, Hokkaido 060‑8543, Japan, Department of Pathology, Sapporo Medical University, Sapporo, Hokkaido 060‑8556, Japan
    Copyright: © Shima et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 14
    |
    Published online on: January 8, 2026
       https://doi.org/10.3892/mco.2026.2923
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Abstract

Seroma formation is one of the unresolved complications of breast cancer surgery. The use of energy devices (EDs) can improve breast cancer surgery outcomes. Dissection of the pectoralis fascia is an important process in total mastectomy, which involves a wide area of the posterior wall of the mammary glands. The current study investigated whether using EDs for this process could lead to a reduction in seroma formation or potentially reduce other complications. In the present observational study, the use of an ED for pectoralis fascia dissection was compared with conventional electrocautery. The main outcomes were the total amount of drainage (total AD), amount of drainage per day and adverse events (AEs) after propensity score matching (PSM). in addition, a univariate analysis of AE occurrence was performed. Overall, 41 and 117 patients were included in the ED and control groups, respectively. PSM was performed for three covariates: Presence or absence of axillary dissection, preoperative chemotherapy and body mass index >25 kg/m2. Compared with those in the control group, the total AD post‑PSM in the ED group did not decrease (P=0.1778), whereas the amount of drainage per day was markedly decreased on postoperative day 8 in the ED group. In the univariate analysis, only the use of ED was associated with a reduction in AEs requiring intervention; other factors showed no significant association. The frequency of AEs requiring intervention was significantly lower in the ED group than that in the control group post‑PSM (P=0.0372). Notably, seroma accounted for most AEs. The results of the present study suggested that pectoralis fascia dissection using an ED may reduce fluid drainage and the incidence of AEs. This simple modification suggests the possibility of improving surgical techniques and is expected to contribute to favorable surgical outcomes. 
View Figures

Figure 1

During a total mastectomy, the
pectoralis major fascia is sealed with an energy device to separate
the pectoralis major muscle and breast tissue. This process is
performed in the area where the pectoralis major muscle is
exposed.

Figure 2

Average amount of drainage per day was
assessed from 1 to 10 days after total mastectomy. Error bars are
standard deviations. (A) Pre-PSM and (B) post-PSM. ED, energy
device; POD, post-operative day; PSM, propensity score
matching.

Figure 3

Plots indicate the correlation between
the drain removal date and length of hospital stay. The shaded area
around the linear model represents the 95% CI. The Pearson s
correlation coefficient was 0.701, indicating a significant
correlation between the drain removal date and length of hospital
stay (95% CI 0.61-0.77; P<0.0001). The respective coefficients
for the ER group and the control group were 0.609 (41 cases) and
0.724 (117 cases), with 95% CIs of (0.62-0.80) and (0.37-0.77),
respectively. CI, confidence interval; ED, energy device.
View References

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Copy and paste a formatted citation
Spandidos Publications style
Shima H, Kondo Y, Nakamura T, Kyuno D, Nishikawa N, Uno S, Noda A, Sato K, Wada A, Mizuguchi T, Mizuguchi T, et al: Reduction of seroma by pectoralis fascia dissection using an energy device in total mastectomy for breast cancer: An observational study&nbsp;. Mol Clin Oncol 24: 14, 2026.
APA
Shima, H., Kondo, Y., Nakamura, T., Kyuno, D., Nishikawa, N., Uno, S. ... Mizuguchi, T. (2026). Reduction of seroma by pectoralis fascia dissection using an energy device in total mastectomy for breast cancer: An observational study&nbsp;. Molecular and Clinical Oncology, 24, 14. https://doi.org/10.3892/mco.2026.2923
MLA
Shima, H., Kondo, Y., Nakamura, T., Kyuno, D., Nishikawa, N., Uno, S., Noda, A., Sato, K., Wada, A., Mizuguchi, T."Reduction of seroma by pectoralis fascia dissection using an energy device in total mastectomy for breast cancer: An observational study&nbsp;". Molecular and Clinical Oncology 24.2 (2026): 14.
Chicago
Shima, H., Kondo, Y., Nakamura, T., Kyuno, D., Nishikawa, N., Uno, S., Noda, A., Sato, K., Wada, A., Mizuguchi, T."Reduction of seroma by pectoralis fascia dissection using an energy device in total mastectomy for breast cancer: An observational study&nbsp;". Molecular and Clinical Oncology 24, no. 2 (2026): 14. https://doi.org/10.3892/mco.2026.2923
Copy and paste a formatted citation
x
Spandidos Publications style
Shima H, Kondo Y, Nakamura T, Kyuno D, Nishikawa N, Uno S, Noda A, Sato K, Wada A, Mizuguchi T, Mizuguchi T, et al: Reduction of seroma by pectoralis fascia dissection using an energy device in total mastectomy for breast cancer: An observational study&nbsp;. Mol Clin Oncol 24: 14, 2026.
APA
Shima, H., Kondo, Y., Nakamura, T., Kyuno, D., Nishikawa, N., Uno, S. ... Mizuguchi, T. (2026). Reduction of seroma by pectoralis fascia dissection using an energy device in total mastectomy for breast cancer: An observational study&nbsp;. Molecular and Clinical Oncology, 24, 14. https://doi.org/10.3892/mco.2026.2923
MLA
Shima, H., Kondo, Y., Nakamura, T., Kyuno, D., Nishikawa, N., Uno, S., Noda, A., Sato, K., Wada, A., Mizuguchi, T."Reduction of seroma by pectoralis fascia dissection using an energy device in total mastectomy for breast cancer: An observational study&nbsp;". Molecular and Clinical Oncology 24.2 (2026): 14.
Chicago
Shima, H., Kondo, Y., Nakamura, T., Kyuno, D., Nishikawa, N., Uno, S., Noda, A., Sato, K., Wada, A., Mizuguchi, T."Reduction of seroma by pectoralis fascia dissection using an energy device in total mastectomy for breast cancer: An observational study&nbsp;". Molecular and Clinical Oncology 24, no. 2 (2026): 14. https://doi.org/10.3892/mco.2026.2923
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