title: Pathophysiology of seroma in breast cancer.
abstract: OBJECTIVE
  Seroma is the most common complication of mastectomy. The aim of this systematic review is to clarify the pathophysiology of seroma.
  
  
  METHODS
  A computer-assisted MEDLINE search was conducted, and additional references were found in the bibliographies of these articles. The reference terms ''breast cancer'', ''mastectomy'', ''seroma'', ''lymphocele'' and ''lymphocyst'' were used as both keyword and subject terms. The search was limited to studies published in English.
  
  
  RESULTS
  The definition of seroma was highly variable across studies, but was most commonly a seroma large enough to be noticed by the patient or medical staff and affecting the patient's satisfaction in the immediate or acute postoperative period. So far, only limited data are available on the severity of seroma. With respect to the pathophysiology of seroma, the data indicated that several anatomical factors, especially dead space, likely contribute to seroma formation. However, it was obscure whether seroma was due to lymph-like fluid or exudate.
  
  
  CONCLUSIONS
  There is considerable variability in the way seroma is defined across studies, and its pathophysiology remains uncertain.
authors.affiliation: Department of Surgery, Showa University Toyosu Hospital, Koutou-ku, Tokyo 135-8577, Japan. kurochan@dd.iij4u.or.jp
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Kuroi
authors.forename: Kojiro
authors.initials: K
authors.lastname: Shimozuma
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Taguchi
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Imai
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Yamashiro
authors.forename: Shozo
authors.initials: S
authors.lastname: Ohsumi
authors.forename: Shinya
authors.initials: S
authors.lastname: Saito
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000009:adverse effects*; D012307:Risk Factors; D049291:Seroma / Q000209:etiology* / Q000503:physiopathology*; D012720:Severity of Illness Index