Erysipelas after surgery for breast cancer: a real-world cohort

Abstract

Erysipelas is often related to lymphedema, which can occur in up to 60% of cases, with advanced age, radiotherapy, tumor extension, surgical approach, and infections as risk factors. The aim of this study was to present and discuss a series of cases of erysipelas after breast cancer surgery treated in a private mastology clinic over the past ten years. This is a retrospective horizontal cohort study in which we selected all cases of erysipelas after breast cancer surgery from 2009 to 2019. The following were evaluated: number of patients treated with a diagnosis of breast carcinoma with axillary approach, age, surgery performed, adjuvant treatment and treatment of erysipelas, presence of lymphedema, and measurement of circumferences between both arms and associated diseases. A total of 12 cases of breast cancer were treated. In 66.66% of cases, a radical axillary lymphadenectomy was performed, and in 16.66% of cases, only a sentinel lymph node investigation was performed. The average age was 67.6 years. Erysipelas appeared, on average, 43 months after cancer diagnosis. Two deaths were reported due to severe erysipelas leading to sepsis. More studies are still needed on the subject. Of the 12 cases in this study, eight (66.66%) were associated with lymphedema. Only two (16.66%) of the patients in this group who developed erysipelas were not submitted to axillary dissection. The treatment for 50% of the participants in this research was with penicillin G benzathine. There were three relapses, and two patients died during the research period.