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Objective:
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.

Results:
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.

Conclusion:
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.