Karin Hedström

I`m a consultant at the Breast Unit, Department of Surgery at Södersjukhuset, Stockholm and a PhD student at the Department of Molecular Medicine and Surgery at Karolinska Institutet. My research focuses on clinical outcomes following breast cancer surgery, with a particular emphasis on outcomes in patients who develop postoperative seroma.

Breast cancer is the most common cancer among women, with approximately 9, 000 cases diagnosed annually in Sweden. Mortality rates have declined, and the improved prognosis is likely related to early detection and advances in adjuvant therapy. Although breast-conserving surgery is the most common procedure for breast cancer, nearly one-quarter of patients still undergo mastectomy. One of the most frequently reported complications following mastectomy is seroma, with incidence rates in different studies reaching up to 90%. A seroma is often described as an accumulation of serous fluid beneath the skin flaps after surgery and may partly result from an acute inflammatory response to surgical trauma.

Seromas are often mild, cause no symptoms, and usually require no intervention. However, in some patients, they can become a prolonged condition requiring repeated interventions. When a seroma needs aspiration, it is referred to as clinically significant seroma and may lead to complications such as delayed wound healing, infection, pain, need for reoperation, and poorer cosmetic outcomes. These complications can, in turn, delay essential adjuvant treatments such as chemotherapy and radiotherapy.

The aim of my thesis is to identify patient- and treatment-related factors that increase the risk of developing clinically significant seroma after mastectomy for breast cancer. In the long term, we hope to contribute to the development of effective strategies to prevent seroma formation. For the individual patient, this would ideally mean fewer follow-up visits, less discomfort and pain, and a reduced risk of delayed oncological treatment.