Abstract

Background: Axillary lymph node dissection (ALND) is the standard of care in the management of the axilla in node-positive breast cancer patients. ALND leads to persistent drainage from the axilla, seroma formation, and lymphedema. The two critical factors linked to seroma production are the formation of inflammatory exudate during the healing process after surgery and leakage from the lymphatics that were cut during the removal of nodes but were not sealed. Low fibrinogen levels and high fibrinolytic activity in the fluid exudate after dissection have increased seroma formation.

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