Abstract
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.
Similar content being viewed by others
References
Kumar S, Lal B, Misra MC (1995) Post-mastectomy seroma: a new look into the aetiology of an old problem. J R Coll Surg Edinb 40:292–294
Akinci M, Cetin B, Aslan S, Kulacoglu H (2009) Factors affecting seroma formation after mastectomy with full axillary dissection. Acta Chir Belg 109:481–483
Kuroi K, Shimozuma K, Taguchi T et al (2006) Evidence-based risk factors for seroma formation in breast surgery. Jpn J Clin Oncol 36:197–206
Pogson CJ, Adwani A, Ebbs SR (2003) Seroma following breast cancer surgery. Eur J Surg Oncol 29:711–717
Oertli D (2000) Axillary lymphadenectomy. Chirurg 78:196–202
Petrek JA, Peters MM, Nori S, Knauer C, Kinne DW, Rogatko A (1990) Axillary lymphadenectomy. A prospective randomized trial of 13 factors influencing drainage including early or delayed arm mobilization. Arch Surg 125:378–382
Gonzalez EA, Saltzstein EC, Riedner CS, Nelson BK (2003) Seroma formation following breast cancer surgery. Breast J 9:385–388
Hashemi E, Kaviani A, Najafi M, Ebrahimi M, Hooshmand H, Montazeri A (2004) Seroma formation after surgery for breast cancer. World J Surg Oncol 2:44
Loo WT, Chow LW (2007) Factors predicting seroma formation after mastectomy for Chinese breast cancer patients. Indian J Cancer 44:99–103
Gong Y, Xu J, Shao J et al (2010) Prevention of seroma formation after mastectomy and axillary dissection by lymph vessel ligation and dead space closure: a randomized trial. Am J Surg 200:352–356
Kakos GS, James AG (1970) The use of cautery in “bloodless” radical mastectomy. Cancer 666–668
Kontos M, Kothari A, Hamed H (2008) Effect of harmonic scalpel on seroma formation following surgery for breast cancer: a prospective randomized study. J BUON 13:223–230
Galatius H, Okholm M, Hoffmann J (2003) Mastectomy using ultrasonic dissection: effect on seroma formation. Breast 12:338–341
Wyman A, Rogers K (1993) Randomized trial of laser scalpel for modified radical mastectomy. Br J Surg 80:871–873
Ridings P, Bailey C, Bucknall TE (1998) Argon beam coagulation as an adjunct in breast-conserving surgery. Ann R Coll Surg Engl 80:61–62
Kerin MJ, O’Hanlon DM, Kenny P, Kent PJ, Given HF (1996) Argon-enhanced cutting and coagulation confers advantages over conventional electrocautery for mastectomy. Eur J Surg Oncol 22:571–573
Porter KA, O’Connor S, Rimm E, Lopez M (1998) Electrocautery as a factor in seroma formation following mastectomy. Am J Surg 176:8–11
Chilson TR, Chan FD, Lonser RR, Wu TM, Aitken DR (1992) Seroma prevention after modified radical mastectomy. Am Surg 58:750–754
Coveney EC, O’Dwyer PJ, Geraghty JG, O’Higgins NJ (1993) Effect of closing dead space on seroma formation after mastectomy – a prospective randomised clinical trial. Eur J Surg Oncol 19:143–146
Classe JM, Dupre PF, François T, Robard S, Theard JL, Dravet F (2002) Axillary padding as an alternative to closed suction drain for ambulatory axillary lymphadenectomy: a prospective cohort of 207 patients with early breast cancer. Arch Surg 137:169–172
Harada RN, Pressler VM, McNamara JJ (1992) Fibrin glue reduces seroma formation in the rat after mastectomy. Surg Gynecol Obstet 175:450–454
El Nakeeb A (2009) Influence of fibrin glue on seroma formation after modified radical mastectomy: a prospective randomized study. Breast J 15:671–672
Sanders RP, Goodman NC, Amiss LR Jr et al (1996) Effect of fibrinogen and thrombin concentrations on mastectomy seroma prevention. J Surg Res 61:65–70
Carless PA, Henry DA (2006) Systematic review and meta-analysis of the use of fibrin sealant to prevent seroma formation after breast cancer surgery. Br J Surg 93:810–819
Jain PK, Sowdi R, Anderson AD, MacFie J (2004) Randomized clinical trial investigating the use of drains and fibrin sealant following surgery for breast cancer. Br J Surg 91:54–60
Cipolla C, Fricano S, Vieni S et al (2010) Does the use of fibrin glue prevent seroma formation after axillary lymphadenectomy for breast cancer? A prospective randomized trial in 159 patients. J Surg Oncol 101:600–603
Sitzmann JV, Dufresne C, Zuidema GD (1983) The use of sclerotherapy for treatment of postmastectomy wound seromas. Surgery 11:233–236
Nichter LS, Morgan RF, Dufresne CR (1983) Rapid management of persistent seromas by sclerotherapy. Ann Plast Surg 11:233–236
Rice DC, Morris SM, Sarr MG et al (2000) Intraoperative topical tetracycline sclerotherapy following mastectomy: a prospective, randomized trial. J Surg Oncol 73:224–227
McCarthy PM, Martin JK Jr, Wells DC, Welch JS, Ilstrup DM (1986) An aborted, prospective, randomized trial of sclerotherapy for prolonged drainage after mastectomy. Surg Gynecol Obstet 162:418–420
O’Hea BJ, Ho MN, Petrek JA (1999) External compression dressing versus standard dressing after axillary lymphadenectomy. Am J Surg 177:450–453
Mansel RE (1998) How long should suction drains stay in after breast surgery with axillary dissection? Ann R Coll Surg Engl 80:376
Gupta R, Pate K, Varshney S, Goddard J, Royle GT (2001) A comparison of 5-day and 8-day drainage following mastectomy and axillary clearance. Eur J Surg Oncol 27:26–30
Barwell J, Campbell I, Watkins RM, Teasdale C (1997) How long should suction drains stay in after breast surgery with axillary dissection. Ann R Coll Surg Engl 79:435–437
Purushotham AD, McLatchie E, Young D et al (2002) Randomized clinical trial of no wound drains and early discharge in the treatment of women with breast cancer. Br J Surg 89:286–292
Puttawibul P, Sangthong B, Maipang T, Sampao S, Uttamakul P, Apakupakul N (2003) Mastectomy without drain at pectoral area: a randomized controlled trial. J Med Assoc Thai 86:325–331
Talbot ML, Magarey CJ (2002) Reduced use of drains following axillary lymphadenectomy for breast cancer. ANZ J Surg 72:488–490
Zavotsky J, Jones RC, Brennan MB, Giuliano AE (1998) Evaluation of axillary lymphadenectomy without axillary drainage for patients undergoing breast-conserving therapy. Ann Surg Oncol 5:227–231
Anand R, Skinner R, Dennison G, Pain JA (2002) A prospective randomised trial of two treatments for wound seroma after breast surgery. Eur J Surg Oncol 28:620–622
Bonnema J, Van Geel AN, Lichtenstein DA, Schmitz PIM, Wiggers TA (1997) A prospective randomised trial of high versus low vacuum drainage after axillary dissection for breast cancer. Am J Surg 173:76–79
Kopelman D, Klemm O, Bahous H, Klein R, Krausz M, Hashmonai M (1999) Postoperative suction drainage of the axilla: for how long? Prospective randomised trial. Eur J Surg 165:117–120
Terrell GS, Singer JA (1992) Axillary vs combined axillary and pectoral drainage after modified radical mastectomy. Surg Gynecol Obstet 175:437–440
Petrek JA, Peters MM, Cirrincione C, Thaler HT (1992) A prospective randomized trial of single versus multiple drains in the axilla after lymphadenectomy. Surg Gynecol Obstet 175:405–409
Saratzis A, Soumian S, Willetts R, Rastall S, Stonelake PS (2009) Use of multiple drains after mastectomy is associated with more patient discomfort and longer postoperative stay. Clin Breast Cancer 9:243–246
Dalberg K, Johansson H, Signomklao T et al (2004) A randomised study of axillary drainage and pectoral fascia preservation after mastectomy for breast cancer. Eur J Surg Oncol 30:602–609
Lotze MT (1981) Early versus delayed shoulder motion following axillary dissection: a randomised prospective study. Ann Surg 193:288–295
Shamley DR, Barker K, Simonite V, Beardshaw A (2005) Delayed versus immediate exercises following surgery for breast cancer: a systematic review. Breast Cancer Res Treat 90:263–271
Suver DW, Perkins JA, Manning SC (2004) Somatostatin treatment of massive lymphorrhea following excision of a lymphatic malformation. Int J Pediatr Otorhinolaryngol 68:845–850
Carcoforo P, Soliani G, Maestroni U et al (2003) Octreotide in the treatment of lymphorrhea after axillary node dissection: a prospective randomized controlled trial. J Am Coll Surg 196:365–369
Disclosures
Financial – Nil
Competing interest – Nil
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sampathraju, S., Rodrigues, G. Seroma Formation after Mastectomy: Pathogenesis and Prevention. Indian J Surg Oncol 1, 328–333 (2010). https://doi.org/10.1007/s13193-011-0067-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13193-011-0067-5