title: Comparison of seroma production in breast conserving surgery with or without intraoperative radiotherapy as tumour bed boost.
abstract: One of the most common complications in breast conserving surgery is seroma formation. The origin of seroma formation remains unclear. While intraoperative radiotherapy (IORT) has been shown to be an alternative to whole breast irradiation, the influence on seroma production is unclear. Therefore, this analysis compares seroma production in patients with breast conserving surgery with or without IORT as tumour bed boost during breast conserving surgery.
  
  
  
  A retrospective analysis of seroma production in patients with nodal-negative (pN0sn) pT1/2 primary breast cancer treated between September 2010 and October 2013 at the Breast Cancer Centre, University Hospital Ulm was performed. Patients with neoadjuvant chemotherapy, previous breast/axillary surgery or more than one intervention were excluded. IORT was applied as a tumour bed boost with 50-kV X-rays (Intra beam(®)) delivering 9 Gy at the applicator surface. Seroma formation was measured using wound drains placed in breast and in axilla.
  
  
  
  Data of 152 patients (99 -IORT; 53 +IORT) were available for analysis. No significant differences between patients with or without IORT with regard to seroma production and number of days until drain removal were found (all p > 0.05).
  
  
  
  Patients with IORT encountered no increased seroma production and removal of the drains was not delayed compared to patients with breast conserving surgery only. Our results indicate that IORT does not increase the seroma production compared to surgery alone.
authors.affiliation: Klinik für Frauenheilkunde und Geburtshilfe, Universität Ulm, Prittwitzstr. 43, 89075, Ulm, Germany. florian.ebner@uniklinik-ulm.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Ebner
authors.affiliation: Klinik für Frauenheilkunde und Geburtshilfe, Universität Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
authors.forename: Amelie
authors.initials: A
authors.lastname: Schramm
authors.affiliation: Klinik für Strahlentherapie und Radioonkologie, Universität Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Bottke
authors.affiliation: Klinik für Frauenheilkunde und Geburtshilfe, Universität Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
authors.forename: Thomas Wp
authors.initials: TW
authors.lastname: Friedl
authors.affiliation: Klinik für Strahlentherapie und Radioonkologie, Universität Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wiegel
authors.affiliation: Klinik für Frauenheilkunde und Geburtshilfe, Universität Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
authors.forename: Visnja
authors.initials: V
authors.lastname: Fink
authors.affiliation: Klinik für Frauenheilkunde und Geburtshilfe, Universität Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
authors.forename: Kristian
authors.initials: K
authors.lastname: Lato
authors.affiliation: Klinik für Frauenheilkunde und Geburtshilfe, Universität Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
authors.forename: Inga
authors.initials: I
authors.lastname: Bekes
authors.affiliation: Klinik für Frauenheilkunde und Geburtshilfe, Universität Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Janni
authors.affiliation: Klinik für Frauenheilkunde und Geburtshilfe, Universität Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: de Gregorio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000150:complications* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D049291:Seroma / Q000209:etiology*
keywords: Breast surgery; IORT; Seroma; Wound drainage