Background: According to the WHO breast cancer is the most common malignant neoplasm in women worldwide by 2020. GLOBOCAN report in 2020, breast cancer remains the most common cancer in Indonesia by 2020, with 65,858 new cases and 22,430 deaths. Surgery is the main method of treatment for breast cancer, one of which is the use of the modified radical mastectomy (MRM) technique. Stewart incision and Songket incision are the approaches used at Mohammad Hoesin Hospital. Seroma is the most frequent complication following mastectomy. Seroma formation increases the risk of postoperative complications, one of which is prolonged healing time. The aim of the study was to evaluate the drainage volume between MRM with a songket design and the Stewart design plus an axillary anchor to offer better surgical options with fewer seroma-related complications. better surgical options with fewer seroma complications and shorter hospital stays.

Methods: A randomized controlled trial using blinding method within two study groups was conducted in breast cancer patients who underwent surgical treatment in the surgical oncology department of Mohammad Hoesin Hospital Palembang from April to May 2022. Patients were divided into two study groups: those who underwent surgery according to the Songket approach and those who underwent surgery according to the Stewart approach with axillary anchoring, The inclusion criteria for the study were patients diagnosed with breast cancer who had undergone MRM surgery and agreed to participate in the study and they signed an informed consent form.

The primary outcome of this study was total drainage volume. Secondary outcomes included drain removal time and length of hospitalization.

Results: The study sample consisted 26 patients (n=13 in each group). Total drainage volume when using the Stewart incision was 378.07 ± 219.57 ml, while when using the Songket incision, it was 174.23 ± 97.44 ml (p= 0.000). Length of hospital stay for surgery using the Stewart incision was 4.46 ± 0.77 days and Songket incision, 3.23 ± 0.43 days (p = 0.005).

Conclusion: There was a significant difference in total drainage volume (p = 0.005) and length of hospital stay (p = 0.000) between study groups.