Keidan R D, Hoffman J P, Weese J L, Hanks G E, Solin L J, Eisenberg B L, Ottery F D, Boraas M
Department of Surgical Oncology, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, Pennsylvania 19111.
Am Surg. 1990 Jul;56(7):440-4.
The incidence of delayed breast abscess as a complication following the treatment of breast cancer has not been reported. A retrospective review of 112 patients (pts) undergoing lumpectomy and radiation therapy (RT) in our institution revealed a six per cent incidence of delayed breast abscess (range 1.5-8 months, median 5 months). Prophylactic antibiotics (P = 1.0), postoperative chemotherapy (P = 1.0), primary vs. re-excisional lumpectomy (P = 1.0), and different surgeons (P = 0.514) were not associated with increased risk of delayed abscess. All abscesses occurred in the first 32 pts of this series. The size of the lumpectomy cavity correlated with the incidence of infection (P = 0.0440). Since six of seven abscess cultures grew staphylococci (coagulase negative three pts, coagulase positive three pts), and four of these pts experienced prior biopsy site infection, skin necrosis or repeated seroma aspirations, a skin source for contamination was suggested. Treatment of the abscesses with antibiotics and immediate drainage produced acceptable but inferior cosmesis. We conclude that a small but significant subset of patients treated with lumpectomy and RT will develop delayed wound infections and that expeditious treatment affords satisfactory cosmesis.
乳腺癌治疗后作为并发症的延迟性乳腺脓肿的发生率尚未见报道。对我院112例行肿块切除术和放射治疗（RT）的患者进行回顾性分析，发现延迟性乳腺脓肿的发生率为6%（范围1.5 - 8个月，中位数5个月）。预防性使用抗生素（P = 1.0）、术后化疗（P = 1.0）、初次肿块切除术与再次肿块切除术（P = 1.0）以及不同的外科医生（P = 0.514）与延迟性脓肿风险增加无关。所有脓肿均发生在该系列的前32例患者中。肿块切除腔的大小与感染发生率相关（P = 0.0440）。由于七份脓肿培养物中有六份培养出葡萄球菌（凝固酶阴性3例，凝固酶阳性3例），且其中4例患者曾有活检部位感染、皮肤坏死或反复抽吸血清肿，提示存在皮肤污染来源。脓肿采用抗生素治疗并立即引流，美容效果尚可但较差。我们得出结论，一小部分但相当数量的接受肿块切除术和放疗的患者会发生延迟性伤口感染，而迅速治疗可获得满意的美容效果。
