title: Obesity predisposes to increased drainage following axillary node clearance: a prospective audit.
abstract: BACKGROUND
  Whilst sentinel node biopsy is being evaluated for optimising treatment of the axilla, axillary dissection remains the gold standard. Seroma formation, a common sequel to axillary dissection, has been shown to be associated with an increased incidence of wound infection, delayed healing, and lymphoedema. This study was conducted to evaluate the possible contributory role of obesity in axillary drainage following lymphatic dissection.
  
  
  METHODS
  This study comprised a prospective review of all patients undergoing axillary dissection in conjunction with mastectomy or wide local excision. The total in-patient axillary drainage and the average daily drainage was correlated with various clinical parameters, including obesity, type of surgery, level of axillary dissection and nodal involvement. The body mass index (BMI) was used as a measure of obesity.
  
  
  RESULTS
  During a 6-month period, axillary dissection was performed in 79 women. Nineteen patients were excluded. Patey mastectomy was performed on 33 (55%) and the remaining had breast conservation. The amount or duration of axillary drainage did not correlate with the type of operation, tumour histology, level of axillary dissection or the nodal status. Higher BMI correlated with increased mean daily axillary drainage and total volume drained, whilst in hospital. (Spearman correlation coefficient 0.42; P < 0.01).
  
  
  CONCLUSIONS
  Obesity predisposes to increased axillary drainage following nodal clearance.
authors.affiliation: Cardiff Breast Unit, Llandough Hospital, Penarth, UK. dibyesh@aol.com
authors.forename: D
authors.initials: D
authors.lastname: Banerjee
authors.forename: E V
authors.initials: EV
authors.lastname: Williams
authors.forename: J
authors.initials: J
authors.lastname: Ilott
authors.forename: I J
authors.initials: IJ
authors.lastname: Monypenny
authors.forename: D J
authors.initials: DJ
authors.lastname: Webster
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D015992:Body Mass Index; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008408:Mastectomy; D008485:Medical Audit; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D012307:Risk Factors