Obesity predisposes to increased drainage following axillary node clearance: a prospective audit

Background: Whilst sentinel node biopsy is being evaluated for optimising t reatment of the axilla, axillary dissection remains the gold standard. Sero ma formation, a common sequel to axillary dissection, has been shown to be associated with an increased incidence of wound infection, delayed healing, and lymphoedema. This study was conducted to evaluate the possible contrib utory role of obesity in axillary drainage following lymphatic dissection. Patients and Methods: This study comprised a prospective review of all pati ents undergoing axillary dissection in conjunction with mastectomy or wide local excision. The total inpatient axillary drainage and the average daily drainage was correlated with various clinical parameters, including obesit y, type of surgery, level of axillary dissection and nodal involvement. The body mass index (BMI) was used as a measure of obesity. Results: During a 6-month period, axillary dissection was performed in 79 w omen. Nineteen patients were excluded. Patey mastectomy was performed on 33 (55%) and the remaining had breast conservation. The amount or duration of axillary drainage did not correlate with the type of operation, tumour his tology, level of axillary dissection or the nodal status. Higher BMI correl ated with increased mean daily axillary drainage and total volume drained, whilst in hospital. (Spearman correlation coefficient 0.42; P < 0.01). Conclusion: Obesity predisposes to increased axillary drainage following no dal clearance.