An analysis of factors that influence the duration of suction drainage in breast cancer surgery.

BACKGROUND: The duration of suction drainage in patients undergoing breast cancer surgery is difficult to predict. The uncertainty this poses may complicate the development of a clinical pathway for patients with breast cancer. In this study we attempted to identify factors that may influence the duration of suction drainage in patients undergoing breast cancer surgery. METHODS: We examined the relationships between the duration of suction drainage and several clinical factors including type of drainage tube in 60 patients with primary breast cancer who underwent surgical resection at the Nippon Medical School Hospital in 2004 and 2005. The drainage tubes were removed 1 day after the daily drainage volume had decreased to less than 50 mL or on the seventh postoperative day in patients in whom such a decrease did not occur. All patients were discharged from the hospital 1 or 2 days after the drains were removed. RESULTS: Seroma was observed in all patients. No complications associated with the drainage were observed. The median duration of drainage was 4.5 days, and the range was 2 to 7 days. Univariate analyses revealed significant relationships between the duration of drainage and the following 5 factors: patient age at surgery, body mass index, intraoperative blood loss, operation time, and type of surgery (total breast resection or partial breast resection). Univariate and multivariate analyses showed no significant statistical associations between the duration of drainage and the other factors, including the type of drainage tube. CONCLUSION: None of the factors examined was strongly associated with the duration of drainage. This study has shown that any type of drainage tube can be used in breast cancer surgery, in regards to the duration of drainage, and that patient discharge 1 or 2 days after drainage tube removal is appropriate.

[A case of elderly metastatic breast cancer with a complete response to treatment with capecitabine and cyclophosphamide].

We report a case of elderly metastatic breast cancer with a complete response to the treatment with XC (X: capecitabine and C: cyclophosphamide). A 78-year-old woman, who presented with left breast cancer, underwent pectoralis-preserving mastectomy when she was 76 years old. Pathological findings were as follows: invasive ductal carcinoma (scirrhous type), pT1c (2.0 cm), n (1/10), ly3, v1, ER (-), PgR (-), HER2: score 1. After one year and a half, a left supraclavicular lymph node metastasis, a left interpectoral lymph node metastasis, and mediastinal lymph nodes metastasis were noted. Capecitabine and cyclophosphamide were administered as first-line chemotherapy. After 8 cycles, all metastases responded, and this therapy is now being continued (19 cycles) on an outpatient basis. The complete response has continued for nine months. XC therapy can be the first-line chemotherapy for elderly metastatic breast cancer patients since it has been effective and no serious side effects have been encountered while maintaining quality of life.