No effect of steroids on seroma formation after mastectomy

Seroma formation is a common problem after breast surgery. Studies indicate that seroma formation is a result of the postoperative inflammatory process. Glucocorticoid inhibits the inflammatory response.

In a randomized pilot study, we measured the effect of glucocorticoid on drainage volume and seroma formation after breast surgery. A total of 42 patients with operable primary breast cancer scheduled for total mastectomy were randomized to either 125 mg methylprednisolone sodium succinate intravenously as a single bolus before the start of surgery or to a control group.

There was no difference between the groups as to the number of patients having drains from day to day. The drainage volume was lower in the methylprednisolone sodium succinate group than in the control group; however, the difference was not significant (7,979 ml versus 9,267 ml). There was a tendency towards a higher seroma formation in the methylprednisolone sodium succinate group, but the tendency was not significant (15,803 versus 13,987 ml), and there was no significant difference in the number of seroma aspirations after surgery (92 versus 99).

Injection of a bolus of 125 mg of methylprednisolone sodium succinate before mastectomy did not reduce drainage volume or seroma formation. If intravenous glucocorticoid did have an effect, the case material was too small to prove it.