Axillary lymphadenectomy for breast cancer in elderly patients and fibrin glue.

Giovanni Docimo,Salvatore Marsico,Paolo Limongelli,Nicola Leone,Giovanni Conzo,Antonio Esposito,Simona Gili,Chiara Vitiello,Domenico Parmeggiani,Alfonso Bosco,Vincenzo Amoroso,Antonia Rizzuto,Landino Fei,Ludovico Docimo

doi:10.1186/1471-2482-13-s2-s8

Giovanni Docimo, Salvatore Marsico + Show 12 more

Open Access

https://doi.org/10.1186/1471-2482-13-s2-s8

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Abstract

BackgroundAxillary lymphadenectomy or sentinel biopsy is integral part of breast cancer treatment, yet seroma formation occurs in 15-85% of cases. Among methods employed to reduce seroma magnitude and duration, fibrin glue has been proposed in numerous studies with controversial results.MethodsThirty patients over 60 years underwent quadrantectomy or mastectomy with level I/II axillary lymphadenectomy; a suction drain was fitted in all patients. Fibrin glue spray were applied to the axillary fossa in 15 patients; the other 15 patients were treated with harmonic scalpel.ResultsSuction drainage was removed between post-operative Days 3 and 4. Seroma magnitude and duration were not significant in patients receiving fibrin glue compared with the harmonic scalpel group.ConclusionsUse of fibrin glue does not always prevent seroma formation, but can reduce seroma magnitude, duration and necessary evacuative punctures.

Highlights

Axillary lymphadenectomy or sentinel biopsy is integral part of breast cancer treatment, yet seroma formation occurs in 15-85% of cases
Many different methodologies have been used in an effort to reduce seroma formation following axillary lymphadenectomy for breast cancer
For patients in the fibrin glue treatment group, following fitting of the drain, fibrin glue prepared with 500 IU/ml of thrombin was applied as a spray (2 ml, from a distance of 10 cm with 2 bars of pressure) at the site of the quadrantectomy or mastectomy

Summary

Introduction

Axillary lymphadenectomy or sentinel biopsy is integral part of breast cancer treatment, yet seroma formation occurs in 15-85% of cases. It is possible to avoid axillary dissection in selected patients (T1 N0) using the sentinel lymph node technique. In all cases where T > 3 cm, and in patients with T1 N1 or with a metastatic sentinel lymph node, conventional axillary lymphadenectomy remains the primary surgical protocol for quadrantectomy and mastectomy. Many different methodologies have been used in an effort to reduce seroma formation following axillary lymphadenectomy for breast cancer. These include suction drainage [6,7] topical application of tetracycline [8], closing

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