Antibiotic prophylaxis in breast cancer surgery. A randomized controlled trial.

PURPOSE: To assess the effect of antibiotic prophylaxis on surgical site infection (SSI) rates in women undergoing breast cancer surgery in two tertiary hospitals in Brazil. METHODS: This was a randomized, double-blind, placebo-controlled, parallel-group clinical trial. A total of 124 women without independent risk factors for SSI were randomly assigned to receive either cefazolin (antibiotic group, n = 62) or placebo (control group, n = 62) as preoperative prophylaxis. After surgery, all surgical wounds were examined once a week, for four weeks, according to the Centers for Disease Control and Prevention definitions and classifications for SSI. RESULTS: Baseline characteristics were homogeneous between the two groups. Only one patient in the antibiotic group developed SSI, which was classified as superficial incisional. The overall SSI rate was low, with no significant difference between groups. CONCLUSION: Antibiotic prophylaxis had no significant effect on reducing SSI rates in women without independent risk factors for SSI undergoing breast cancer surgery.

Antibiotic prophylaxis in breast cancer surgery. A randomized controlled trial

Abstract Purpose To assess the effect of antibiotic prophylaxis on surgical site infection (SSI) rates in women undergoing breast cancer surgery in two tertiary hospitals in Brazil. Methods This was a randomized, double-blind, placebo-controlled, parallel-group clinical trial. A total of 124 women without independent risk factors for SSI were randomly assigned to receive either cefazolin (antibiotic group, n = 62) or placebo (control group, n = 62) as preoperative prophylaxis. After surgery, all surgical wounds were examined once a week, for four weeks, according to the Centers for Disease Control and Prevention definitions and classifications for SSI. Results Baseline characteristics were homogeneous between the two groups. Only one patient in the antibiotic group developed SSI, which was classified as superficial incisional. The overall SSI rate was low, with no significant difference between groups. Conclusion Antibiotic prophylaxis had no significant effect on reducing SSI rates in women without independent risk factors for SSI undergoing breast cancer surgery.

Cirurgia oncoplástica e reconstrutiva da mama: Reunião de Consenso da Sociedade Brasileira de Mastologia / Oncoplastic and reconstructive surgery of the breast: Consensus Meeting of the Brazilian Society of Mastology

Objetivo: Apesar do grande número de publicações em cirurgia oncoplástica e reconstrutiva da mama, diversas questões permanecem controversas. Assim, o objetivo desta Reunião de Consenso, foi desenvolver um guia prático de recomendações baseadas nas melhores evidências disponíveis na literatura. Método: Os painelistas foram os membros da Comissão de Cirurgia Oncoplástica e Reconstrutiva da Sociedade Brasileira de Mastologia. A reunião foi realizada em agosto de 2015 em Bento Gonçalves (RS). Cada painelista recebeu e respondeu previamente um questionário com 46 itens, com base na melhor evidencia cientifica e em sua experiência. Foi considerado consenso a concordância de 75% entre painelistas. Resultados: Houve consenso em 25 itens, dos quais para oito houve concordância de 100%. O mais importantes foram: comprometimento das margens em cirurgia oncoplástica pode ser resolvido com ampliação de margens na maioria dos casos; tumores multifocais não são contraindicação para cirurgia oncoplástica; idade >70 anos não representa contraindicação para uso de técnicas oncoplásticas; reconstrução imediata pode ser indicada com segurança para a maioria das candidatas à mastectomia; pacientes com indicação de radioterapia pós-mastectomia podem ser submetidas à reconstrução imediata, devendo ter ciência dos riscos maiores para mau resultado estético; mastectomia com preservação do complexo areolopapilar é segura nos casos de câncer; radioterapia após a mastectomia com preservação do complexo areolopapilar não está indicada fora dos critérios clássicos de irradiação do plastrão; tela abdominal reduz chances de hernia no caso de reconstrução com TRAM. Conclusão: através desta reunião foi possível estabelecer importantes pontos consensuais de acordo com a opinião dos especialistas, que poderão auxiliar os mastologistas na tomada de decisões em cirurgias oncoplásticas e reconstrutivas da mama.

Objective: Despite the large number of publications in oncoplastic and breast reconstructive surgery, several issues remain controversial. The aim of this Consensus Meeting was to develop a practical guide of recommendations based on the best evidence in the literature. Method: All panelists were members of the Oncoplastic Commission of the Brazilian Society of Mastology. The Consensus Meeting was held in Bento Gonçalves (RS), in August 2015. Each panelist received and answered a questionnaire with 46 items, based on the best evidence in the literature and in their expertise. It was considered consensus the agreement of 75% between panelists. Results: There was consensus on 25 items, of which eight were for 100% agreement. The most important of these topics were: involvement of the margins in oncoplastic surgery can be solved by resection of margins in most cases; multifocal tumors is not a contraindication for oncoplastic surgery; age >70 years is not a contraindication for use of oncoplastic techniques; immediate reconstruction can be performed safely to most candidates for mastectomy; patients for post-mastectomy radiotherapy may be subject to immediate reconstruction and should be aware of the risks for poor aesthetic result; mastectomy with preservation of the nipple and areola complex is safe in cancer; radiotherapy after mastectomy with preservation of the nipple and areola complex is not indicated outside the classical criteria of irradiation chest wall; abdominal mash reduces chances of hernia in TRAM flaps. Conclusion: In this meeting it was possible to establish important consensus points according to the opinion of experts, which can help breast surgeons in their decision-making in oncoplastic and reconstructive surgery of the breast.