Case Report of International Journal of Case Reports
Successful surgical management of chronic bilateral encapsulated seroma after node-negative breast cancer: A Case Report
Kjersti Fosheim1*, Sophie Bojesen2, Hannah Troestrup2 and Anne-Vibeke Laenkholm1
1Department of Surgical Pathology, Zealand University Hospital, Roskilde, Denmark. 2Department of Plastic Surgery, Zealand University Hospital, Roskilde, Denmark.
Background: Chronic encapsulated seroma following breast cancer surgery is a rare entity, and management is challenging. We present clinical and pathologic findings in a patient with extensive history of bilateral refractory breast seroma successfully treated with capsulectomy.
Case presentation: A 71-year-old woman with previous early BRCA2 associated, node-negative breast cancer, developed late onset seroma following endocrine therapy, unilateral breast-conserving surgery, and completion of adjuvant radiotherapy. Non-simultaneous bilateral mastectomy was later performed to treat infection and reduce risk of contralateral breast cancer. Each surgery was followed by chronic seroma. After six years of ineffective treatment attempts with repeated aspirations, the patient successfully underwent bilateral capsulectomy. She remains seroma-free nine months from time of capsulectomy.
Conclusion: This is the first report of late onset bilateral encapsulated breast seroma following mastectomy without axillary dissection. When managing breast seroma refractory to conventional treatment encapsulated seroma and prompt capsulectomy should be considered.
Keywords: Breast cancer, encapsulated seroma, capsulectomy, case report
How to cite this article:
Kjersti Fosheim, Sophie Bojesen, Hannah Troestrup and Anne-Vibeke Laenkholm. Successful surgical management of chronic bilateral encapsulated seroma after node-negative breast cancer: A Case Report. International Journal of Case Reports, 2021, 5:251. DOI: 10.28933/ijcr-2021-09-27051
1. van Bemmel AJM, van de Velde CJH, Schmitz RF, Liefers GJ. Prevention of seroma formation after axillary dissection in breast cancer: A systematic review. Eur J Surg Oncol EJSO. 2011 Oct;37(10):829–35.
2. Kuroi K, Shimozuma K, Taguchi T, Imai H, Yamashiro H, Ohsumi S, et al. Pathophysiology of seroma in breast cancer. Breast Cancer. 2005 Oct;12(4):288–93.
3. Boostrom SY, Throckmorton AD, Boughey JC, Holifield AC, Zakaria S, Hoskin TL, et al. Inci-dence of Clinically Significant Seroma after Breast and Axillary Surgery. J Am Coll Surg. 2009 Jan;208(1):148–50.
4. Gonzalez EA, Saltzstein EC, Riedner CS, Nelson BK. Seroma Formation Following Breast Cancer Surgery. Breast J. 2003 Sep;9(5):385.
5. Kuroi K, Shimozuma K, Taguchi T, Imai H, Yamashiro H, Ohsumi S, et al. Evidence-Based Risk Factors for Seroma Formation in Breast Surgery. Jpn J Clin Oncol. 2006 Apr 1;36(4):197–206.
6. Awad GA, Chan Q. Encapsulated chronic recur-rent seroma following modified radical mastec-tomy: surgical resection and reconstruction by muscle-sparing latissimus dorsi flap—a case report and review of literature. Ann Breast Surg [Internet]. 2020 Jun 30;4(0). Available from: https://abs.amegroups.com/article/view/5900
7. Ebner F, Friedl TWP, de Gregorio A, Lato K, Bekes I, Janni W, et al. Seroma in breast surgery: all the surgeons fault? Arch Gynecol Obstet. 2018 Nov;298(5):951–9.
8. Hashemi E, Kaviani A, Najafi M, Ebrahimi M, Hooshmand H, Montazeri A. Seroma formation after surgery for breast cancer. World J Surg Oncol. 2004;2(1):44.
9. Loo WT, Chow LW. Factors predicting seroma formation after mastectomy for Chinese breast cancer patients. Indian J Cancer. 2007 Sep;44(3):99–103.
10. Say CC, Donegan W. A biostatistical evaluation of complications from mastectomy. Surg Gynecol Obstet. 1974 Mar;138(3):370–6.
11. Kumar S, Lal B, Misra MC. Post-mastectomy seroma: a new look into the aetiology of an old problem. J R Coll Surg Edinb. 1995 Oct;40(5):292–4.
12. Coveney EC, O’Dwyer PJ, Geraghty JG, O’Higgins NJ. Effect of closing dead space on seroma formation after mastectomy–a prospec-tive randomized clinical trial. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. 1993 Apr;19(2):143–6.
13. Tejler G, Aspegren K. Complications and hospital stay after surgery for breast cancer: A prospective study of 385 patients. Br J Surg. 1985 Jul 1;72(7):542–4.
14. Stanczyk M, Grala B, Zwierowicz T, Maruszynski M. Surgical resection for persistent seroma, fol-lowing modified radical mastectomy. World J Surg Oncol. 2007 Sep 23;5:104.
15. van Bastelaar J, van Roozendaal LM, Meesters-Caberg M. Surgical removal of fibrous axillary seroma pocket and closing of dead space using a lattisimus dorsi flap. J Surg Case Rep [Internet]. 2018 Mar 1;2018(3). Available from: https://doi.org/10.1093/jscr/rjy032
16. Georgiou G, Lianos G, Batsis H, Harissis (Χαρίσης) H (Χαράλαμπος). Surgical treatment of persistent axillary seroma following modified radical mastectomy; A case report and review of the literature. Surg Chron. 2012 Oct 1;17:275–7.
17. PAN X-F, HUAN J-L, QIN X-J. Potential risk factors for the development of seroma following mastectomy with axillary dissection. Mol Clin Oncol. 2015 Jan;3(1):222–6.
18. Skriver SK, Laenkholm A-V, Rasmussen BB, Handler J, Grundtmann B, Tvedskov TF, et al. Neoadjuvant letrozole for postmenopausal es-trogen receptor-positive, HER2-negative breast cancer patients, a study from the Danish Breast Cancer Cooperative Group (DBCG). Acta Oncol Stockh Swed. 2018 Jan;57(1):31–7.
19. Matsui Y, Yanagida H, Yoshida H, Imamura A, Kamiyama Y, Kodama H. Seroma with fibrous capsule formation requiring a surgical resection after a modified radical mastectomy: report of a case. Surg Today. 1998;28(6):669–72.
This work and its PDF file(s) are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.