Factors Affecting Seroma Formation after Mastectomy with Full Axillary Dissection

Akıncı, Melih; Çetin, Bahadır; Aslan, Sabahattin; Kulaçoğlu, Hakan

doi:10.1080/00015458.2009.11680464

Cited by 37 publications

(30 citation statements)

References 10 publications

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“…Mastectomies likely lead to a more extensive damage to vascular and lymphatic structures than breast-conservation surgery, thus resulting in an increased incidence of fluid collection formation. Other reported risk factors for accumulation of fluid include age, BMI > 30, diabetes, radiation, hypertension and increased initial drainage via surgical drains [7–10]. …”

Section: Discussionmentioning

confidence: 99%

“…Although the pathophysiology of breast fluid collection remains unclear, studies have identified several risk factors and predictors such as age and BMI > 30 [7–11]. Other researchers also examined various mechanical and chemical techniques to obliterate the dead space during surgery to reduce breast fluid formation after mastectomy [12–14].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Outcomes of Percutaneous Drainage of Breast Fluid Collections after Mastectomy with Expander-based Breast Reconstruction

Tong

Kohi

Fidelman

et al. 2013

Journal of Vascular and Interventional Radiology

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PURPOSE To determine clinical outcomes of patients who underwent imaging-guided percutaneous drainage of breast fluid collections following mastectomy and breast reconstruction. MATERIAL AND METHODS Retrospective review included all consecutive patients who underwent percutaneous drainage of fluid collections following mastectomy with tissue expander-based reconstruction between January 2007 and September 2012. A total of 879 mastectomies (563 patients) with expander-based breast reconstruction were performed during this period. 28 patients (5%) developed fluid collections, which led to 30 imaging-guided percutaneous drainage procedures. The median follow up time was 533 days. Patient characteristics, surgical technique, microbiology analysis, and clinical outcomes were reviewed. RESULTS The mean age was 51.5 years (range 30.9 to 69.4 years) and the median time between breast reconstruction and drainage was 35 days (range 4 to 235 days). Erythema and swelling were the most common presenting symptoms. The median volume of fluid evacuated at the time of drain placement was 70 mL. Drains were left in place for a median 14 days (range 6 to 34 days). Microorganisms were detected in the fluid in 12 of 30 drainage procedures, with Staphylococcus aureus being the most common microorganism. No further intervention was needed in 21 of 30 drainage procedures (70%). However, surgical intervention (removal of expanders) was needed following 6 (20%) drainages, and additional percutaneous drainage procedures were performed following 3 (10%) drainages. CONCLUSION Percutaneous drainage is an effective means of treating post operative fluid collections after expander-based breast reconstruction and can obviate the need for repeat surgery in most cases.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes of Percutaneous Drainage of Breast Fluid Collections after Mastectomy with Expander-based Breast Reconstruction

Tong

Kohi

Fidelman

et al. 2013

Journal of Vascular and Interventional Radiology

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“…This presumed complication, albeit usually of minor consequence, may prolong recovery, length of hospital stay and over stretch health budget. The reported incidence of seroma formation varies widely between 15 and 18% [2]. There are several factors implicated in seroma formation like the extent of lymph node clearance, number of positive nodes, the use of postoperative radiation and whether intraoperative lymphatic channel ligation was done or not, but opinion differs as to their individual role in its pathogenesis [2,3].…”

Section: Introductionmentioning

confidence: 99%

Seroma Formation after Mastectomy: Pathogenesis and Prevention

Sampathraju

Rodrigues

2010

Indian J Surg Oncol

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Post mastectomy seroma remains an unresolved quandary as the risk factors for its formation have still not been identified. Seromas of the axillary space following breast surgery can lead to significant morbidity and delay in the initiation of adjuvant therapy. Various techniques and their modifications have been practiced and published in English literature, but there seems to be no consensus. In this article, all aspects of seroma formation from pathogenesis to prevention including drug therapies have been discussed.

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“…Although there are a number of treatment choices available, surgery is still the first-line treatment [22], and modified radical mastectomy is the major management method [23]. Sentinel lymph nodes have been increasingly found in IMLNs in conjunction with sentinel lymph node biopsies [24].…”

Section: Discussionmentioning

confidence: 99%

Clinical Implications of Micrometastasis Detection in Internal Mammary Nodes of Breast Cancer Patients

Zeng¹,

Xie²,

Lu³

et al. 2012

Breast Care

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Breast CareFor a long time, mastectomy was routinely used to establish local control. However women now have the option of breastconserving treatment followed by radiotherapy [4,5]. The lymph nodes outside the axilla, including the internal mammary lymph nodes (IMLNs), are not usually resected in the operation [6,7]. Recently sentinel lymph node biopsy has been identified as a new diagnostic procedure to determine KeywordsBreast cancer · Internal mammary nodes · Micrometastasis ·Step-serial sectioning SummaryBackground: The aim of this study was to assess the efficiency of step-serial sectioning (SSS) combined with hematoxylin and eosin (H&E) and immunohistochemical (IHC) staining in detecting micrometastasis of internal mammary lymph nodes (IMLNs). Patients and Methods: 135 IMLNs from 88 breast cancer patients were re-examined by SSS, combined with either H&E or IHC staining of the biomarkers cytokeratin-19 and epithelial membrane antigen. Results: Of the 135 IMLNs, 6 nodes from 5 cases displayed 1 or more micrometastases. Histological grade and lymphovascular invasion status were significantly correlated with micrometastasis in the IMLNs (p = 0.018 and 0.001, respectively). Of the 6 nodes positive for micrometastasis, 1 node was detected by both H&E and IHC staining. The remaining 5 nodes from 4 cases showed evident tumor cells only by IHC staining. Finally 8 of the 83 patients (9.64%) without IMLN metastasis showed distant metastasis, while 2 of the 5 patients (40%) with IMLN metastasis showed distant metastasis within 28 months of operation. Conclusion: SSS combined with H&E and IHC staining is more efficient in detecting micrometastasis than classic routine single-slice H&E only.

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Factors Affecting Seroma Formation after Mastectomy with Full Axillary Dissection

Abstract: It is concluded that hypertension and a drainage flow rate greater than 40 mL/day for more than 7 days predict seroma formation following breast cancer surgery.

Cited by 37 publications

References 10 publications

Clinical Outcomes of Percutaneous Drainage of Breast Fluid Collections after Mastectomy with Expander-based Breast Reconstruction

Clinical Outcomes of Percutaneous Drainage of Breast Fluid Collections after Mastectomy with Expander-based Breast Reconstruction

Seroma Formation after Mastectomy: Pathogenesis and Prevention

Clinical Implications of Micrometastasis Detection in Internal Mammary Nodes of Breast Cancer Patients

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