Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patients / carers / community to improve efficiency / quality of care)
Authors (including presenting author) :
Wong L(1), Cheung HH (1), Lau YC (1), Suen TKD(1), Kwong A(1)
Affiliation :
Department of Surgery, Queen Mary Hospital, and Tung Wah Hospital
Introduction :
Seroma is a collection of fluid that forms after breast cancer surgery, which can increase the risk of infection, discomfort, and emotional distress. Lymphatic fluid is one of the essential components for seroma formation due to lymphatic damage during surgery. Our hypothesis was that a low-fat, high-protein diet could reduce lymphatic fluid production, leading to a lower incidence of subsequent seroma intervention.
Objectives :
This pilot case-control study aimed to assess the effect of diet modification on patients at a higher risk of developing seroma after breast cancer surgery.
Methodology :
The study was conducted at the Department of Surgery in Queen Mary and Tung Wah Hospital between July to December 2021 and 2022. Selection criteria included patients with obesity (defined by body mass index (BMI) of over 25kg/m2) who had mastectomy with or without axillary surgery, or breast conservative surgery with axillary surgery. A drainage tube was inserted during the operation and removed if the output was less than 25 ml daily for two consecutive days. A control group (n=54) was selected from a historical cohort of patients treated in 2021 in the same institutes who did not receive any dietary intervention. While in 2022, 16 patients were recruited and provided with a low-fat, high-protein diet. A dietitian was consulted on postoperative day 1 to recommend dietary modifications.
Result & Outcome :
Results and Outcomes: There was no significant difference between the two groups regarding patients’ age, BMI, tumor size, type of operation, lymph node status, operation time, hypertension, or diabetes mellitus (DM) status. However, the diet group demonstrated a significant decrease in total drain output (564 +/- 337 ml) compared to the control group (992 +/- 793 ml) (P=0.04). The diet group also had a shorter duration of drain usage (14.0 +/- 4.9 days) compared to the control group (20.4 +/- 8.7 days) (P=0.007). However, there was no significant difference in subsequent seroma intervention between the two groups (22% in the diet group vs. 25% in the control group, p=0.819). Conclusion: This pilot study demonstrated that a low-fat, high-protein diet after breast cancer surgery could significantly decrease the total drain output and drain usage duration, potentially leading to a decrease in comorbidities associated with prolonged drain use. Considering the small sample size and the case-control study design, a prospective randomized controlled trial (RCT) should be conducted to evaluate the effects of the diet.
