Comparison of the Frequency of Wound Infection in Patients Undergoing Toilet Mastectomy Versus Simple Mastectomy in Patients with Fungating Breast Tumor at Tertiary Care Hospital, Karachi

Authors

  • Manal Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
  • Prinka Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
  • Rashid Ali Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
  • Hamra Afridi Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
  • Rafia Wakil Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
  • Mansab Ali Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan

DOI:

https://doi.org/10.70749/ijbr.v3i7.2580

Keywords:

Breast cancer, Fungating tumor, Toilet mastectomy, Simple mastectomy, Wound infection, Surgical outcomes, Postoperative complications, Breast surgery.

Abstract

Background: Fungating breast tumors often require palliative surgical intervention. However, the optimal approach for minimizing postoperative wound infection remains unclear. This study compared the frequency of wound infections following toilet mastectomy and simple mastectomy in patients treated at a tertiary care hospital. Methods: This randomized controlled trial was conducted in the Department of Surgery at JPMC, Karachi, over a period of six months. We enrolled 68 patients with fungating breast tumors and assigned them to one of two surgical groups. One group was toilet mastectomy (Group A) and the other groups was simple mastectomy (Group B). We documented wound infections postoperatively and examined associations with age, education, income, and occupational status. Results: Group A had a lower rate of wound infection (14.7%) compared to Group B (41.2%). Although the difference did not reach statistical significance (p = 0.15). Patients with lower education levels and those who were employed showed a slightly higher infection rate across both groups, but these patterns were not statistically significant. Conclusion: Toilet mastectomy appeared to reduce the frequency of wound infection rates compared to simple mastectomy in patients with fungating breast tumors.

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References

1. Abrejo FG, Shaikh BT, Saleem S. ICPD to MDGs: Missing links and common grounds. Reprod Health. 2008;5:4.

https://doi.org/10.1186/1742-4755-5-4

2. Malik SS, Mubarik S, Aftab A, Khan R, Masood N, Asif M, Bano R. Correlation of MSH2 exonic deletions and protein downregulation with breast cancer biomarkers and outcome in Pakistani women/patients. Environ Sci Pollut Res Int. 2020;9:1–2.

https://doi.org/10.1007/s11356-020-10717-z

3. Ahtesham K, Nisar B, Tabassum T, Imran AA. Spectrum of breast lesions on fine needle aspiration cytology in Punjab. Biomedica. 2020;36:409.

https://doi.org/10.24911/biomedica/5-151

4. Garg PK, Prakash G. Current definition of locally advanced breast cancer. Curr Oncol. 2015;22:409.

https://doi.org/10.3747/co.22.2697

5. Parton M, Dowsett M, Ashley S, Hills M, Lowe F, Smith IE. High incidence of HER-2 positivity in inflammatory breast cancer. Breast. 2004;13:97–103.

https://doi.org/10.1016/j.breast.2003.08.004

6. Merz T, Klein C, Uebach B, Kern M, Ostgathe C, Bükki J. Fungating wounds-multidimensional challenge in palliative care. Breast Care. 2011;6:21–24.

https://doi.org/10.1159/000324923

7. Adderley UJ, Holt IG. Topical agents and dressings for fungating wounds. Cochrane Database Syst Rev. 2014;5.

https://doi.org/10.1002/14651858.cd003948.pub3

8. Maqsood B, Zeeshan MM, Rehman F. Breast cancer screening practices and awareness in women admitted to a tertiary care hospital of Lahore, Pakistan.. J Pak Med Assoc. 2009;59.

9. Bhurgri Y, Nazir K, Shaheen Y, et al. Patho-epidemiology of cancer cervix in Karachi South. Asian Pac J Cancer Prev. 2007;8:357. [PubMed] [Google Scholar]

10. Raza S, Sajun SZ, Selhorst CC. Breast cancer in Pakistan: identifying local beliefs and knowledge. J Am Coll Radiol. 2012;9:571–577.

https://doi.org/10.1016/j.jacr.2012.02.020

11. Moriarty JM, Xing M, Loh CT. Particle embolization to control life- threatening hemorrhage from a fungating locally advanced breast carcinoma: a case report. J Med Case Rep. 2012;6:1–6.

https://doi.org/10.1186/1752-1947-6-186

12. Rohith M. Prospective Study of Wound Complications After Breast Surgery for Breast Cancer Following Neoadjuvant Chemotherapy [Master’s thesis]. Rajiv Gandhi University of Health Sciences; 2022.

https://doi.org/10.36106/ijsr/5201929

13. Nyaoncha AN. Surgical site infection rates in breast cancer surgery at a university hospital in Nairobi, Kenya. East and Central African Journal of Surgery. 2021;26(1):34–39.

14. Ayoade BA, Salami BA, Opadeyi E, Adekoya AO, Fatungase OM. Complications of mastectomy for breast cancer in a tertiary care centre in South-west Nigeria. Ann Health Res. 2020;6(1):108–113.

https://doi.org/10.30442/ahr.0601-12-72

15. Hoefer RA, DuBois JJ, Ostrow LB, Fuller Silver L. Wound complications following modified radical mastectomy: An analysis of perioperative factors. The Journal of the American Osteopathic Association. 1990 Jan 1;90(1):47- 53.

https://doi.org/10.1515/jom-1990-900109

16. Adwall L, Hultin H, Mani M, Norlén O. Prospective evaluation of complications and associated risk factors in breast cancer surgery. Journal of Oncology. 2022;2022(1):6601066.

https://doi.org/10.1155/2022/6601066

17. Lopez-de-Andres A, Jimenez-Trujillo I, Hernandez-Barrera V, de Miguel- Diez J, Mendez-Bailon M, de Miguel-Yanes JM, Perez-Farinos N, Salinero- Fort MA, Del Barrio JL, Romero-Maroto M, Jimenez-Garcia R. Association of type 2 diabetes with in-hospital complications among women undergoing breast cancer surgical procedures. A retrospective study using the Spanish National Hospital Discharge Database, 2013–2014. BMJ open. 2017 Nov 1;7(11):e017676.

https://doi.org/10.1136/bmjopen-2017-017676

18. Lewin R, Göransson M, Elander A, Thorarinsson A, Lundberg J, Lidén M. Risk factors for complications after breast reduction surgery. Journal of plastic surgery and hand surgery. 2014 Feb 1;48(1):10-4.

https://doi.org/10.3109/2000656x.2013.791625

19. Farzan JJ, Guart JA, Kulkarni N, Roberts S, De La Cruz-Ku G, Czerniach DR, Dinh KH. Managing Necrotizing Soft-Tissue Infection in Breast Cancer: A Case of Emergency Toilet Mastectomy. The American Journal of Case Reports. 2025 May 12;26:e946669.

https://doi.org/10.12659/ajcr.946669

20. Dahri FJ, Awan MS, Qazi AR, Khaskheli NM, Soomro IA. Early wound complications following modified radical mastectomy with axillary clearance. J Surg Pak (Int). 2011 Oct;16:4

21. See MH, Sinnadurai S, Lai LL, Tan KL, Teh MS, Teoh LY, Jamaris S, Malik RA, Bhoo-Pathy N. Outcomes after mastectomy with immediate breast reconstruction for breast cancer in a multiethnic, middle-income Asian setting. Surgery. 2021 Dec 1;170(6):1604-9.

https://doi.org/10.1016/j.surg.2021.08.001

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Published

2025-07-19

How to Cite

Manal, Prinka, Ali, R., Afridi, H., Wakil, R., & Ali, M. (2025). Comparison of the Frequency of Wound Infection in Patients Undergoing Toilet Mastectomy Versus Simple Mastectomy in Patients with Fungating Breast Tumor at Tertiary Care Hospital, Karachi. Indus Journal of Bioscience Research, 3(7), 1290-1293. https://doi.org/10.70749/ijbr.v3i7.2580