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Seroma in breast surgery: all the surgeons fault?

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Despite a trend for less radical surgical approaches in breast cancer due to better understanding of tumour biology and new treatment options such as neoadjuvant chemotherapy (NAC) and intra-operative radiotherapy (IORT), seroma production remains one of the main surgical side effects that can result in prolonged recovery, delay of radiotherapy and patient discomfort. The aim of this study is to provide an update on risk factors for seroma production after breast cancer surgery considering the latest treatment options.

Methods

A retrospective analysis of seroma production in primary breast cancer patients treated between 01.01.2010 and 31.12.2014 at the Breast Cancer Centre, University Hospital Ulm, was performed. Patients with previous breast/axillary surgery or more than one intervention were excluded. Seroma formation was measured using wound drains placed in breast and axilla.

Results

In total, 581 patients met the inclusion criteria. Median age at diagnosis was 60 years, and median BMI 25.6 kg/m2. 60 (10.3%) patients had a mastectomy, 175 (30.1%) patients received IORT, and 72 (12.4%) patients received NAC. Median amount of seroma production was 82.5 ml (range 0–3012.5 ml). Multivariate analysis revealed that most of the observed variation in seroma production was due to type of surgery (mastectomy vs. breast conserving), length of surgery and number of removed lymph nodes. Both NAC and IORT explained a significant but very small amount of the observed variation in seroma production.

Conclusion

The most important factors for seroma production are extent and duration of breast surgery.

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Funding

No external or additional funding was used for this study.

Author information

Author notes

  1. Florian Ebner and Thomas W. P. Friedl contributed equally.

Authors and Affiliations

  1. Klinik für Frauenheilkunde und Geburtshilfe, Universität Ulm, Prittwitzstr. 43, 89075, Ulm, Germany

    Florian Ebner, Thomas W. P. Friedl, Amelie de Gregorio, Krisztian Lato, Inga Bekes, Wolfgang Janni & Nikolaus de Gregorio

Authors
  1. Florian Ebner
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  2. Thomas W. P. Friedl
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  3. Amelie de Gregorio
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  4. Krisztian Lato
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  5. Inga Bekes
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  6. Wolfgang Janni
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  7. Nikolaus de Gregorio
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Contributions

FE: conceptualization, writing original draft, review and editing. TWPF: data curation, formal analysis. AG: resources. KL: supporting. IB: validation. WJ: supervision. NG: conceptualization, review and editing.

Corresponding author

Correspondence to Nikolaus de Gregorio.

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Conflict of interest

All authors declare that they have no potential conflict of interest.

Ethical approval

This study was approved by the local ethic committee.

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Ebner, F., Friedl, T.W.P., de Gregorio, A. et al. Seroma in breast surgery: all the surgeons fault?. Arch Gynecol Obstet 298, 951–959 (2018). https://doi.org/10.1007/s00404-018-4880-8

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  • DOI: https://doi.org/10.1007/s00404-018-4880-8

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