title: Incidence and prognostic factors for seroma development after MammoSite breast brachytherapy.
abstract: OBJECTIVE
  Describe the incidence and identify risk factors for seroma development after MammoSite breast brachytherapy (MBT).
  
  
  METHODS
  MBT patient data were prospectively recorded into a quality assurance database. Departmental and electronic records were reviewed to extract patient-, treatment-, and outcome-specific data. Stepwise logistic regression analysis was performed to identify factors associated with development of any seroma including the subset of clinically significant seroma (CSS). CSS was defined as a symptomatic seroma requiring multiple aspirations, biopsy, and/or excision. Variables analyzed included age, weight, number of excisions, time from resection to catheter placement, placement technique, balloon volume, dosimetric factors, and postbrachytherapy infection.
  
  
  RESULTS
  MBT was performed in 109 patients, of whom 97 had minimum 6 months (median, 36) post-MBT follow-up or earlier development of seroma. All patients received 34 Gy to 1cm depth from balloon surface, delivered twice daily in 10 fractions. Seroma developed in 41% of patients at a median of 3 months (range, 0.1-25) post-MBT. One-third of seromas (13% of all patients) were CSS. The only factor identified as statistically significant for development of any seroma was catheter placement on day of resection vs. > or =1 day later (59% vs. 33%; p = 0.0066). Post-MBT infection was highly statistically significant for development of CSS (64% vs. 7%; p<0.0001). Prophylactic antibiotics reduced the risk of post-MBT infection from 37.5% to 6% (p = 0.011).
  
  
  CONCLUSIONS
  The incidence of CSS after MBT is low. Post-MBT infection is statistically significantly associated with CSS development, the incidence of which is reduced with prophylactic antibiotics.
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Watkins
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Harper
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Dragun
authors.forename: Michael S
authors.initials: MS
authors.lastname: Ashenafi
authors.forename: Debajyoti
authors.initials: D
authors.lastname: Sinha
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: David J
authors.initials: DJ
authors.lastname: Cole
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Jenrette
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects* / Q000295:instrumentation*; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000009:adverse effects*; D008875:Middle Aged; D011446:Prospective Studies; D049291:Seroma / Q000209:etiology*; D013530:Surgical Wound Infection / Q000150:complications
references.citation: Arch Surg. 1989 Feb;124(2):153-7
references.pmid: 2916935
references.citation: Jpn J Clin Oncol. 2006 Apr;36(4):197-206
references.pmid: 16684859
references.citation: Am J Surg. 2007 Oct;194(4):456-62
references.pmid: 17826055
references.citation: Am J Surg. 2006 Oct;192(4):427-33
references.pmid: 16978943
references.citation: Arch Surg. 2004 Jun;139(6):603-7; discussion 607-8
references.pmid: 15197085
references.citation: Wound Repair Regen. 2003 Sep-Oct;11(5):326-30
references.pmid: 12950635
references.citation: Radiother Oncol. 2006 Jun;79(3):316-20
references.pmid: 16780977
references.citation: Am Surg. 2006 Oct;72(10):929-34
references.pmid: 17058738
references.citation: J Clin Oncol. 1992 Mar;10(3):356-63
references.pmid: 1445509
references.citation: Am Surg. 2000 May;66(5):444-50; discussion 450-1
references.pmid: 10824744
references.citation: Am J Surg. 2005 Oct;190(4):530-8
references.pmid: 16164915
references.citation: Surg Clin North Am. 2007 Apr;87(2):431-51, x
references.pmid: 17498536
references.citation: Int J Radiat Oncol Biol Phys. 2006 Jun 1;65(2):333-9
references.pmid: 16545918