title: Complications of mastectomy and their relationship to biopsy technique.
abstract: BACKGROUND
  Wound complication rates after mastectomy are associated with several factors, but little information is available correlating biopsy technique with the development of postmastectomy wound complications. Fine-needle aspiration (FNA) biopsy is an accurate method to establish a diagnosis, but it is unknown whether this approach has an impact on complications after mastectomy.
  
  
  METHODS
  Charts of 283 patients undergoing 289 mastectomies were reviewed to investigate any association between biopsy technique and postmastectomy complications.
  
  
  RESULTS
  The diagnosis of breast cancer was made by FNA biopsy in 50%, open biopsy in 49.7%, and core needle biopsy in 0.3%. The overall wound infection rate was 5.3% (14 of 266), but only 1.6% when FNA biopsy was used compared with 6.9% with open biopsy (p = 0.06). Among 43 patients undergoing breast reconstruction concomitantly with mastectomy, the infection rate was 7.1% (0% after FNA, 12% after open biopsy). Neither the development of a postoperative seroma (9.8%) nor skin flap necrosis (5.6%) was influenced by the biopsy technique used.
  
  
  CONCLUSIONS
  These data suggest that wound infections after mastectomy may be reduced when the diagnosis of breast cancer is established by FNA biopsy.
authors.affiliation: Department of Surgery, Medical College of Virginia, Richmond 23298-0011, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Lipshy
authors.forename: J P
authors.initials: JP
authors.lastname: Neifeld
authors.forename: R M
authors.initials: RM
authors.lastname: Boyle
authors.forename: W J
authors.initials: WJ
authors.lastname: Frable
authors.forename: S
authors.initials: S
authors.lastname: Ronan
authors.forename: P
authors.initials: P
authors.lastname: Lotfi
authors.forename: H D
authors.initials: HD
authors.lastname: Bear
authors.forename: J S
authors.initials: JS
authors.lastname: Horsley
authors.forename: W
authors.initials: W
authors.lastname: Lawrence
mesh_terms: D001706:Biopsy / Q000009:adverse effects* / Q000379:methods; D001707:Biopsy, Needle / Q000009:adverse effects; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects; D008408:Mastectomy / Q000009:adverse effects*; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000209:etiology