Preoperative core needle biopsy as an independent risk factor for wound infection after breast surgery

Diverging findings concerning the rate of postoperative wound infections in patients undergoing breast surgery have been reported, and little is known regarding the possible risk factors for these infections and their relative importance. We assessed risk factors for wound infection, placing particular emphasis on the influence of preoperative procedures such as core needle biopsy.

In a prospective evaluation of 326 patients undergoing breast surgery, we identified risk factors for wound infections by univariate analysis and subsequent step-wise multiple logistic regression. Assessment of wound infection was based on a simple wound scoring system.

Of the 326 patients, 50 (15.3%) developed wound infections. As expected, after univariate analysis a higher proportion of postsurgical infections was observed in patients with diabetes (33.3% versus 14.3%; odds ratio [OR] = 3.00, 95% confidence interval [CI] 1.109, 8.157; P =.03) and malignant tumors (21.2% versus 6.8%; OR = 3.716, 95% CI 1.762, 7.849; P <.001). Patients with wound infections were significantly older than those without (mean age 63.73 versus 51.44 years, P <.001). Surprisingly, patients who underwent core needle biopsy, which in most cases was performed within 1-3 days before breast surgery, were also at significantly higher risk for developing a wound infection (22.3% versus 9.6%; OR = 2.718, 95% CI 1.454, 5.076; P =.001). This effect remained unchanged when controlled for potential confounders by step-wise multiple logistic regression.

In breast surgery, the independent risk factors for wound infections are older age and preoperative core needle biopsy.