Abstract P2-12-06: Prevention of seroma formation after mastectomy by local methylprednisolone injection - A randomized controlled clinical trial

Abstract

Abstract Objective: To investigate the effect of local steroid administration on seroma formation until 14 days of dryness. Background: Seroma formation, the most prevalent postoperative complication after mastectomy, is an inflammatory process that is potentially preventable via local steroid administration. Methods: This double-blind, randomized, placebo-controlled intervention study included 212 women who were scheduled for mastectomy for primary breast cancer. The patients were classified according to the surgical axillary procedure: mastectomy with sentinel lymph node biopsy (M+SLNB) or mastectomy with level I-II axillary lymph node dissection (M+ALND). The participants received either 80 mg of methylprednisolone or saline intracavitary via the drain orifice upon drain removal. Results: After M+SLNB, 46% (32 of 69) of the patients developed seromas in the steroid group vs. 78% (52 of 67) in the saline group (p<0.0001). The mean cumulative seroma volume in the intention-to-treat material for the first 10 and 30 days was significantly lower in the steroid group than in the saline group (24 vs.127 mL and 177 vs. 328 mL, respectively) (p<0.0001). After M+ALND, 94% of the patients developed seromas in both the steroid (35 of 37) and saline (34 of 36) groups, and steroid administration displayed no significant effect on seroma formation. Additionally, no difference in the infection rate was observed. Conclusion: Methylprednisolone administered intracavitary on the first postoperative day after M+SLNB exerted a highly significant preventive effect against seroma formation during the first 30 days. Future studies may clarify whether higher or repeated steroid doses enhance these effects. Citation Format: Qvamme G, Axelsson CK, Lanng C, Wegeberg B, Mortensen MB, Okholm M, Arpi MR, Szecsi PB. Prevention of seroma formation after mastectomy by local methylprednisolone injection - A randomized controlled clinical trial. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-12-06.