ROLE OF TETRACYCLINE IN PREVENTION OF POSTMODIFIED RADICAL MASTECTOMY SEROMA; RANDOMIZED CONTROL STUDY

Abstract

Breast cancer is the most frequent female cancer with an estimated 2 million new cases were
diagnosed worldwide [1].
Nowadays, modified radical mastectomy (MRM) is the principal treatment of breast cancer,
provides sufficient tumor clearance, and decrease the local recurrence rate [2].
Seroma is the commonest post-Mastectomy complication. and known as a collection of serous
fluid combined with blood, plasma, and lymph fluid under the skin flap. As early sequel after MRM [3-
4].
In the current literature incidence of postmastectomy seroma formation ranged from 3% up to
90% [3].
Seroma is the noisiest event for the patient and the surgeon. Seroma formation can lead to
patient discomfort, repeated seroma aspirations with the risk of infection, prolonged hospital stay,
delayed wound healing, skin flap necrosis, delay in receiving adjuvant therapies and extended hospital
stay may be required which increases costs for the patient and healthcare system and higher surgical
expenditures [5].
Despite numerous trials of new techniques which have attempted to reduce the incidence of
seroma formation, no single method appears to be uniformly effective.
Recently, many researchers developed variable techniques to prevent seroma formation.
reduction of dead space was the main principle of these techniques [6]. Variable methods for reduction
of dead space were reported; use of suction drain, antibiotics like Tetracycline, adhesive tissue glues as
fibrin glue, natural coagulation factors, and Octreotide [7].
Topical sclerotherapy with Tetracycline has long been used successfully in the treatment of
malignant pleural effusions to cause obliteration of the pleural space [8]. The first report of
Tetracycline sclerotherapy for treating seromas after mastectomy was by Sitzmann et al. [9].
In the current study we evaluate the effectiveness of using Tetracycline and closure of the dead
space in reducing seroma after Modified Radical Mastectomy.