Risk factors for breast cellulitis following breast conservation therapy : a case-control study of 51 women

Breast conservation therapy is a treatment option for women with early stage breast cancer. A minority of women who undergo breast conservation therapy develop breast cellulitis, an infection of the skin and subcutaneous tissues. This complication, which results in a prolonged length of recovery for the patient, poses problems for both the physician and patient.

The risk factors for breast cellulitis are unclear. The objective of this study was to identify risk factors associated with breast cellulitis by comparing patients that developed breast cellulitis with control patients who did not develop breast cellulitis. A matched case-control study, consisting of 17 cases and 34 controls, was performed to analyze potential risk factors for breast cellulitis speculated in the published literature, along with a series of other potential factors not mentioned in the literature. A retrospective review of the patient records was conducted for each case and control. Statistical analyses indicated the following factors are associated with breast cellulitis: drainage of a hematoma, postoperative ecchymosis, lymphedema, volume of resected breast tissue, previous number of biopsies, and number of breast seroma aspirations. This study also identified risk factors that may have been statistically significant provided a larger sample size was studied.

To date, this is the first matched case-control study analyzing potential risk factors associated with breast cellulitis. It also includes the largest sample of breast cellulitis cases studied to date. Sample size, however, still acted as a limiting factor. A prospective study should be conducted to further substantiate the significant and potentially significant risk factors identified in this study.