title: Symptomatic Axillary Seroma after Sentinel Lymph Node Biopsy: Incidence and Treatment.
abstract: Postoperative seroma is a nuisance for patients and surgeons. Few studies investigate predisposing factors for axillary seroma after sentinel lymph node biopsy (SLNB). We sought to quantitate the risk of symptomatic seroma and characterize interventions.
  
  
  
  We performed a retrospective review of 667 women undergoing breast-conserving surgery and SLNB at our institution between July 2007 and January 2015. Surgeons dissected sharply or with standard electrocautery. We correlated patient and tumor characteristics with symptomatic seroma using logistic regression models for univariate and multivariate predictors. All statistical tests were two sided, with p < 0.05 considered significant.
  
  
  
  Overall, 127 (19 %) of 667 women had axillary seromas and 98 (77 %) of 127 required further intervention for symptom relief. Seroma patients were similar in age, BMI, race, tumor type, T and N stage, and number of nodes removed as those without (all p > 0.07). Seroma rates did not vary according to surgeon, nodal mapping technique, or axillary closure technique (p = 0.8789). Multivariate analysis identified diabetes, smoking, and SSI as predictors of symptomatic axillary seroma with odds ratio of 1.97, 1.98, and 37.19 (all p < 0.017), respectively. Among the 98 of 127 patients with seroma, most (81 of 98, 83 %) resolved with a mean of 1.3 aspirations. The remainder resolved after axillary drain (13 of 98, 13 %) or additional surgery (4 of 98, 4 %).
  
  
  
  Symptomatic axillary seroma occurs in 14 % patients undergoing breast-conserving surgery with SLNB and is not influenced by tumor, nodal mapping, or surgeon characteristics. Management infrequently requires more than simple aspiration. Drain placement at initial surgery may be considered in smokers or patients with diabetes.
authors.affiliation: Department of Surgery, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Jinny
authors.initials: J
authors.lastname: Gunn
authors.affiliation: Department of Surgery, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Tammeza
authors.initials: T
authors.lastname: Gibson
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Li
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Diehl
authors.affiliation: Department of Surgery, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Bagaria
authors.affiliation: Department of Surgery, Mayo Clinic, Jacksonville, FL, USA. mclaughlin.sarah@mayo.edu.
authors.forename: Sarah
authors.initials: S
authors.lastname: McLaughlin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D003920:Diabetes Mellitus / Q000453:epidemiology; D004322:Drainage; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008197:Lymph Node Excision / Q000009:adverse effects*; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects*; D049291:Seroma / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery*; D012907:Smoking / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology