Delayed breast cellulitis: an evolving complication of breast conservation.

Area of Science:

• Oncology
• Infectious Disease

Background:

• Delayed breast cellulitis (DBC) presents as late-onset erythema, edema, tenderness, and warmth in the breast.
• It occurs after breast cancer treatment, necessitating analysis of risk factors and clinical course.

Purpose of the Study:

• To analyze risk factors and clinical course of delayed breast cellulitis (DBC).
• To identify associations between patient characteristics, treatment details, and DBC development.

Main Methods:

• Retrospective analysis of 601 patients with T0-2N0-1 breast cancers treated with breast conserving therapy from 1985-2004.
• DBC cases identified by clinical criteria (>3 months post-surgery, >3 weeks post-radiotherapy).
• Analysis of patient comorbidity, operative technique, complications, and adjunctive therapy.

Main Results:

• Overall incidence of DBC was 8% (50/601).
• Significant risk factors included obesity, ecchymoses, T stage, breast hematoma/seroma, >5 axillary lymph nodes removed, and arm lymphedema.
• Median onset was 226 days post-surgery; 92% treated with antibiotics, 22% had recurrent episodes, 4% required mastectomy.

Conclusions:

• DBC is multifactorial, likely a bacterial infection with impaired lymphatic drainage, appearing months after radiotherapy.
• Empirical antibiotic treatment is generally recommended before invasive testing.