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ARTICLE |

Axillary Lymphadenectomy for Breast Cancer Without Axillary Drainage

Stefanie S. Jeffrey, MD; William H. Goodson, MD; Debra M. Ikeda, MD; Robyn L. Birdwell, MD; Martin S. Bogetz, MD
Arch Surg. 1995;130(8):909-913. doi:10.1001/archsurg.1995.01430080111018.
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Objective:  To evaluate axillary lymph node dissection done without closed drainage in conjunction with breast conservation cancer surgery.

Design:  Prospective clinical study.

Setting:  Two university hospitals.

Patients:  Eighty-one women undergoing wide local excision of breast cancer with simultaneous or subsequent axillary lymph node dissection.

Interventions:  No axillary drain was placed following axillary lymphadenectomy.

Main Outcome Measures:  The development and resorption of axillary seroma fluid as measured by clinical aspiration and serial sonographic examination.

Results:  Thirty-four (42%) of the 81 women required axillary seroma aspiration even though axillary fluid was present in 92% (22/24) of those studied sonographically. The seromas accumulated over the first 2 weeks following axillary dissection and resorbed over the next 2 weeks, as assessed by both clinical and sonographic examination. The complication rate was 2% (2/81). The surgery was performed safely on an outpatient or short-stay basis in 99% (80/81) of patients. All patients except one were discharged within 23 hours of surgery, and 56 patients were discharged directly after anesthesia.

Conclusion:  Axillary lymph node dissection done in conjunction with breast conservation surgery can be performed in an ambulatory or short-stay setting without axillary drainage. Postoperative seromas will resolve within 1 month, and fewer than half will require aspiration. Lymphadenectomy without drainage reduces morbidity and allows the patient greater personal comfort.(Arch Surg. 1995;130:909-913)

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