Optimization of the prognosis of postoperative complications in patients with breast cancer

Background. Breast cancer (BC) is the most prevalent malignant neoplasm among women, requiring surgical treatment in early stages. Despite the implementation of breast-conserving surgeries, the prevention of early postoperative wound complications remains a significant challenge, as their development leads to delays in adjuvant treatment, prolonged recovery periods, and deterioration in patients' quality of life. Objective: to optimize the prediction of postoperative complications in breast cancer patients by developing a novel surgical approach and a method for predicting wound complications based on local thermometry and microcirculation assessment. Materials and Methods. This single-center comparative retrospective study included 210 patients with stage 0-IB breast cancer, divided into two groups: the study group (n = 105) who underwent surgery using the developed Z-shaped approach, and the control group (n = 105) who underwent surgery with the standard linear approach. The groups were comparable in age, disease stage, comorbidities, and molecular-biological tumor type. Microcirculation was assessed using the "LAKK-M" laser analyzer, while thermometry was performed using the CG320 thermal imaging hardware-software complex with the "IR MED" program. Pain syndrome was evaluated using the Verbal Rating Scale (VRS) and the Pain Intensity Questionnaire. Results. The Z-shaped approach significantly reduced the incidence of early postoperative complications to 3.8% compared to 27.6% with the classical approach (p < 0.05). The frequency of inflammatory infiltrates in the postoperative wound area in the study group was 1.9% versus 11.4% in the control group (p < 0.05), and the frequency of seromas was 1.9% versus 14.2%, respectively (p < 0.05). ROC analysis showed that microcirculation was the primary predictor of wound complications (AUC = 0.673; 95% CI 0.507-0.710; p = 0.03). At microcirculation values below 15 perfusion units, the sensitivity for inflammatory infiltrate development was 35.7% with a specificity of 92.9%, while for seroma prediction, sensitivity was 71.4% and specificity was 60.2%. Conclusions. The developed Z-shaped approach for breast-conserving surgeries and the method for predicting early postoperative complications based on microcirculation assessment and local thermometry significantly reduce the frequency of early postoperative complications and allow for timely prediction of their development, contributing to optimized treatment of early-stage breast cancer patients.

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