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The Dilemma of Delayed Cellulitis After Breast Conservation Therapy

Edgar D. Staren, MD, PhD; Steven Klepac, MD; Andrew P. Smith, MD; William F. Hartsell, MD; John Segretti, MD; Thomas R. Witt, MD; Katherine L. Griem, MD; Steven D. Bines, MD
Arch Surg. 1996;131(6):651-654. doi:10.1001/archsurg.1996.01430180077016.
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Objective:  To determine the clinicopathologic characteristics of patients with breast cancers in whom delayed breast cellulitis developed after conservation therapy (lumpectomy, axillary dissection, and radiation).

Background:  Breast cellulitis developing after conservation therapy represents a difficult diagnostic and management dilemma because determination of its origin may be necessary before further treatment decisions can be made.

Methods:  In this retrospective evaluation of 184 sequential patients with breast cancers who underwent conservation therapy, 10 study patients (5%) in whom breast cellulitis developed 3 or more months after surgery were compared with the 174 patients in whom cellulitis did not develop.

Results:  There was no significant difference in clinicopathologic characteristics of the study patients compared with control patients. The cellulitis resolved in 5 patients (50%) and persisted from 4 months to more than 1 year in 5 patients (50%). The cellulitis recurred in 1 patient who responded to repeated therapy. The 5 patients with persistent cellulitis underwent biopsies, and recurrent cancer was found in 1 patient. Recurrent cancer did not develop in the patients whose cellulitis resolved within 4 months with a minimum follow-up of 24 months.

Conclusions:  Delayed-onset cellulitis occurs in a small percentage of patients with breast cancers treated by conservation therapy. The cellulitis may take several weeks to clear, and/or it may recur or persist. If the condition persists after 4 months of therapy, a biopsy should be performed to rule out recurrent cancer.(Arch Surg. 1996;131:651-654)


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