Breast conservation therapy consisted of local re-excision (quadrantectomy, other) and axillary node dissection if invasive carcinoma was present. Most of the patients apparently received radiation therapy.
Cellulitis was defined as the acute development of erythema, swelling, warmth and tenderness (i.e., inflammation) of the remaining breast after breast conservation surgery.
Major risk factor:
(1) lymphedema of the breast
Additional risk factors:
(1) drainage of a hematoma
(2) aspiration of a breast seroma
(3) large volume of breast tissue resected (range in patients with cellulitis was 19.7 to 396 cubic cm with median 178; range for controls was 19 to 366 cubic cm with median 107)
(4) previous number of breast biopsies in the ipsilateral breast (this appears to include the biopsy used to diagnose the tumor)
Protective factor:
(1) postoperative ecchymosis
Differential diagnosis:
(1) radiation effect
(2) inflammatory breast carcinoma (would not be treated with conservative surgery)
(3) reaction to retained sutures
Limitations:
• The authors were unable to perform a multiple logistic regression due to the limited sample size.
• I am not sure how best to use breast volume since there is such a large overlap. It might be interesting to compare volume resected to preoperative volume of the breast.
• Some of the discussion seems muddled.
• The cases developed 7 days to 3.6 years after surgery. Thus some would be post-operative infections while others would be unrelated to acute surgical events.
