Complete axillary dissection without drainage for the surgical treatment of breast cancer: a randomized clinical trial

• Main Authors: Ruffo Freitas-Junior, Luís Fernando Jubé Ribeiro, Marise Amaral Rebouças Moreira, Geraldo Silva Queiroz, Maurício Duarte Esperidião, Marco Aurélio Costa Silva, Rubens José Pereira, Rossana Araújo Catão Zampronha, Rosemar Macedo Sousa Rahal, Leonardo Ribeiro Soares, Danielle Laperche dos Santos, Maria Virginia Thomazini, Cassiana Ferreira Silva de Faria, Régis Resende Paulinelli
• Format: Article
• Language: English
• Published: Faculdade de Medicina / USP
• Series: Clinics
• Subjects: Breast Cancer; Breast-conserving Surgery; Lymph Node Excision; Drainage; Postoperative Complications
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322017000700426&lng=en&tlng=en

OBJECTIVE: This randomized clinical trial evaluated the possibility of not draining the axilla following axillary dissection. METHODS: The study included 240 breast cancer patients who underwent axillary dissection as part of conservative treatment. The patients were divided into two groups depending on whether or not they were subjected to axillary drainage. ClinicalTrials.gov: NCT01267552. RESULTS: The median volume of fluid aspirated was significantly lower in the axillary drainage group (0.00 ml; 0.00 - 270.00) compared to the no drain group (522.50 ml; 130.00 - 1148.75). The median number of aspirations performed during conservative breast cancer treatment was significantly lower in the drainage group (0.5; 0.0 - 4.0) compared to the no drain group (5.0; 3.0 - 7.0). The total volume of serous fluid produced (the volume of fluid obtained from drainage added to the volume of aspirated fluid) was similar in the two groups. Regarding complications, two cases (2.4%) of wound dehiscence occurred in the drainage group compared to 13 cases (13.5%) in the group in which drainage was not performed, with this difference being statistically significant. Rates of infection, necrosis and hematoma were similar in both groups. CONCLUSION: Safety rates were similar in both study groups; hence, axillary dissection can feasibly be performed without drainage. However, more needle aspirations could be required, and there could be more cases of wound dehiscence in patients who do not undergo auxiliary drainage.