E2749. Breast Sclerosis is an Effective and Minimally Invasive Outpatient Procedure for Recurrent Post-Operative Seroma
  1. Claire Sorek; Henry Ford Hospital
  2. Nicholas Laucis; Henry Ford Hospital
  3. Dominic Semaan; Henry Ford Hospital
Breast seroma formation is a common postoperative complication. Postoperative seromas can be difficult to treat requiring multiple aspirations, compression clothing, and often surgical intervention. Doxycycline injection to induce sclerosis is a common technique in body interventional radiology. A pilot study was performed in collaboration with breast surgeons to investigate ultrasound-guided doxycycline sclerosis procedures to treat postoperative breast seromas.

Materials and Methods:
Breast sclerosis was performed on 29 patients for postlumpectomy or postmastectomy seromas that recurred after simple aspiration. After ultrasound-guided catheter placement and seroma aspiration, 500 mg of doxycycline constituted in 10 mL sterile saline was injected into the seroma and left for 30 - 60 minutes, after which the doxycycline solution was aspirated. For seroma aspiration volumes <50 mL, the doxycycline solution volume injected was reduced to 50% of the aspirated volume.

Thirteen patients were injected with 500 mg of doxycycline with 2 patients requiring 2 sclerosis attempts, and none requiring surgery for treatment following sclerosis. Eight patients were injected with between 200 and 500 mg of doxycycline with 1 requiring 2 sclerosis attempts, and none requiring surgery. Eight patients were injected with less than 200 mg of doxycycline, 2 requiring 4 attempts and 1 requiring 6 attempts, and 1 requiring surgery. No major complications occurred. One patient had an unknown allergy to doxycycline, which was treated with oral diphenhydramine.

Breast sclerosis is an effective minimally invasive treatment for postoperative breast seromas offering a less morbid and less costly option for patients. This procedure represents an area in which interventional radiologists can offer great value to breast surgery colleagues.