[Postoperative fever and prognosis in breast cancer]

Retrospectively 378 patients with primary cancer of all stages, treated between 1975 and 1982 were studied again after an interval of at least 3 years. During this time 75 (19.8%) tumor recurrences were observed; in 47 cases (12.4%) distant metastases and in 28 cases (7.4%) local recurrences. Fever was defined as body temperature above 37.5 degrees C from the second postoperative day onward. Postoperative fever occurred in 45% of the patients; stage I 41%, stage II 45%, stage III 59% and stage IV 50%. Considering tumor recurrence there was a fever frequency of 69%, irrespective of stage, which in stage III reached 86% in cases with distant metastases and even 100% in cases with local recurrence. In comparison fever frequency in patients without evidence of recurrence was 36% to 40%. The relative risk of recurrence after postoperative fever increases significantly: in stage II 2.4 times and in stage III 10.6 times. Analysis of postoperative fever revealed, that short drainage time below 6 days and volumes of drained fluid below 400 ml were prognostically infavorable, while wound complications were not associated with an increased risk of tumor recurrence.