Reduced use of drains following axillary lymphadenectomy for breast cancer

Background: Axillary dissection is frequently performed during the treatment of operable breast cancer, and is associated with certain morbidities. Accumulation of axillary fluid, otherwise known as a seroma, is a frequent complication that appears to be related to the degree of dissection. Based on empirical evidence, surgeons have attempted to reduce the occurrence and duration of seromas by using suction drainage, but this concept has been challenged by several authors. Objective: To determine if the natural history of seroma fluid accumulation after axillary surgery is altered by the duration of suction drainage or non-placement of a drain. Methods: Ninety consecutive patients having axillary dissection for breast cancer had either prolonged suction drainage (mean 9.6 days), short duration drainage (2 days), or had no drain placed. Seromas were aspirated and the time to cessation of fluid accumulation determined, as well as any other wound complications. Results: There was no difference in the number of wound complications or the duration of fluid accumulation between the three groups, being 26.6, 25.7, and 27.9 days, respectively. Patients having no drains placed required more frequent aspirations. Conclusions: The duration of seroma fluid accumulation is not altered by the placement of a suction drain following axillary lymphadenectomy.