An aborted, prospective, randomized trial of sclerotherapy for prolonged drainage after mastectomy

Annually, approximately 100 of the 400 postmastectomy patients we studied have persisting serous drainage. Sclerotherapy with the use of tetracycline has been advocated to decrease serous drainage and the formation of seromas. Reports in the literature suggest that the use of tetracycline for treatment has been efficacious and that it is not painful. We devised a prospective, randomized controlled trial to study the effects of tetracycline on patients with prolonged persisting drainage. Six patients in the control group had the drains left in place until the drainage diminished. One of these patients had a seroma develop after the drains were removed. Eight patients were treated with tetracycline. Four of these patients had seromas develop after the drains were removed. Three of the eight patients had severe reactions of pain when the tetracycline was introduced into the drains. Because of the severe pain associated with sclerotherapy treatment and the lack of demonstrable benefit in those treated, we terminated the study. We did not find tetracycline to be of help in treating patients with prolonged drainage after mastectomy and some of those patients had severe pain develop from the treatment.