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A prospective study on delayed shoulder exercises in reducing seroma formation after modified radical mastectomy

  • Prospective Randomized Study
  • Published:
Hellenic Journal of Surgery



Seroma formation is a well-known complication after modified radical mastectomy (MRM) for breast cancer. Another well known complication is shoulder movement dysfunction following the same operation. Traditionally, patients were asked to perform exercises of the shoulders as early as possible after surgery in the belief that it reduces subsequent shoulder dysfunction. The aim of this study was to evaluate whether delayed shoulder exercises after MRM could reduce seroma formation without compromising the outcome of shoulder mobility.


Fifty patients who underwent MRM were randomly divided into two groups, the early group and the delayed group, each consisting of 25 patients. Shoulder exercises were started in the patients allotted to the ‘early group’ from postop day 1, while those in the ‘delayed group’ began shoulder exercises from postop day 7. Seroma formation and other complications were closely noted. Their follow-up at one month and six months was assessed for shoulder movement dysfunction using the Constant scoring system.


There was significant increase in seroma formation in the ‘early group’ (79 %) compared to the ‘delayed group’ (p-value 0.027469) with an odds ratio of 5.76 [1.36, 24.36]. However, there was no significant difference in the shoulder dysfunction between both groups when measured after one month (p-value 0.889576) and six months (p-value 0.396509).


The incidence of seroma after MRM is reduced by delaying shoulder exercises by one week rather than one day. The early initiation of shoulder exercises to avoid impairment of shoulder movements is not necessary.

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Correspondence to Shamita Chatterjee.

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Chatterjee, S., Ryntathiang, I. A prospective study on delayed shoulder exercises in reducing seroma formation after modified radical mastectomy. Hellenic J Surg 87, 165–168 (2015).

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