The dilemma of delayed cellulitis after breast conservation therapy.
OBJECTIVE
To determine the clinicopathologic characteristics of patients with breast cancers in whom delayed breast cellulitis developed after conservation therapy (lumpectomy, axillary dissection, and radiation).


BACKGROUND
Breast cellulitis developing after conservation therapy represents a difficult diagnostic and management dilemma because determination of its origin may be necessary before further treatment decisions can be made.


METHODS
In this retrospective evaluation of 184 sequential patients with breast cancers who underwent conservation therapy, 10 study patients (5%) in whom breast cellulitis developed 3 or more months after surgery were compared with the 174 patients in whom cellulitis did not develop.


RESULTS
There was no significant difference in clinicopathologic characteristics of the study patients compared with control patients. The cellulitis resolved in 5 patients (50%) and persisted from 4 months to more than 1 year in 5 patients (50%). The cellulitis recurred in 1 patient who responded to repeated therapy. The 5 patients with persistent cellulitis underwent biopsies, and recurrent cancer was found in 1 patient. Recurrent cancer did not develop in the patients whose cellulitis resolved within 4 months with a minimum follow-up of 24 months.


CONCLUSIONS
Delayed-onset cellulitis occurs in a small percentage of patients with breast cancers treated by conservation therapy. The cellulitis may take several weeks to clear, and/or it may recur or persist. If the condition persists after 4 months of therapy, a biopsy should be performed to rule out recurrent cancer.
Staren
E D
ED
Department of General Surgery, Rush-Presbyterian-St Luke's Medical Center, Chicago, III, USA.
Klepac
S
S
Smith
A P
AP
Hartsell
W F
WF
Segretti
J
J
Witt
T R
TR
Griem
K L
KL
Bines
S D
SD
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000532:radiotherapy / Q000601:surgery; D018275:Carcinoma, Lobular / Q000532:radiotherapy / Q000601:surgery; D002481:Cellulitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011182:Postoperative Care; D011183:Postoperative Complications; D011879:Radiotherapy Dosage; D012008:Recurrence; D012189:Retrospective Studies; D013629:Tamoxifen / Q000627:therapeutic use; D013997:Time Factors
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen