The dilemma of delayed cellulitis after breast conservation therapy

Arch Surg. 1996 Jun;131(6):651-4. doi: 10.1001/archsurg.1996.01430180077016.

Abstract

Objective: To determine the clinicopathologic characteristics of patients with breast cancers in whom delayed breast cellulitis developed after conservation therapy (lumpectomy, axillary dissection, and radiation).

Background: Breast cellulitis developing after conservation therapy represents a difficult diagnostic and management dilemma because determination of its origin may be necessary before further treatment decisions can be made.

Methods: In this retrospective evaluation of 184 sequential patients with breast cancers who underwent conservation therapy, 10 study patients (5%) in whom breast cellulitis developed 3 or more months after surgery were compared with the 174 patients in whom cellulitis did not develop.

Results: There was no significant difference in clinicopathologic characteristics of the study patients compared with control patients. The cellulitis resolved in 5 patients (50%) and persisted from 4 months to more than 1 year in 5 patients (50%). The cellulitis recurred in 1 patient who responded to repeated therapy. The 5 patients with persistent cellulitis underwent biopsies, and recurrent cancer was found in 1 patient. Recurrent cancer did not develop in the patients whose cellulitis resolved within 4 months with a minimum follow-up of 24 months.

Conclusions: Delayed-onset cellulitis occurs in a small percentage of patients with breast cancers treated by conservation therapy. The cellulitis may take several weeks to clear, and/or it may recur or persist. If the condition persists after 4 months of therapy, a biopsy should be performed to rule out recurrent cancer.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery*
  • Carcinoma, Ductal, Breast / radiotherapy
  • Carcinoma, Ductal, Breast / surgery*
  • Carcinoma, Intraductal, Noninfiltrating / radiotherapy
  • Carcinoma, Intraductal, Noninfiltrating / surgery
  • Carcinoma, Lobular / radiotherapy
  • Carcinoma, Lobular / surgery
  • Cellulitis / diagnosis
  • Cellulitis / drug therapy
  • Cellulitis / etiology*
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Lymph Node Excision*
  • Mastectomy, Segmental*
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Postoperative Care
  • Postoperative Complications
  • Radiotherapy Dosage
  • Recurrence
  • Retrospective Studies
  • Tamoxifen / therapeutic use
  • Time Factors

Substances

  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents
  • Antineoplastic Agents, Hormonal
  • Tamoxifen