Recommendations:
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Preoperative prophylactic antibiotics (PPAs) are indicated in patients undergoing:
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Mastectomy, with or without any type of axillary dissection or reconstruction, to lower the risk of SSI.
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- PPAs may be indicated in patients undergoing:
- Partial mastectomy for cancer, with or without sentinel lymph node biopsy or axillary dissection.
- Oral antibiotics or PPAs may be considered in patients undergoing:
- Brachytherapy catheter device placement for APBI.
- PPAs may be used in patients undergoing:
- Simple surgical excisional biopsy, especially if specific patient or clinical risk factors for SSI are present.
- A first-generation cephalosporin is the PPA of choice, unless the patient is allergic or has a history of prior infection with MRSA.
- Continuation of antibiotics after the initial PPA is discouraged unless there is a specific clinical indication.
- If SSI occurs:
- Aerobic and anaerobic cultures should be obtained and sensitivity of any available SSI fluid should be determined.
- Culture and sensitivity reports should prompt appropriate changes in antibiotic management.
- If SSI rates are used as a quality metric (QM), then standardized ascertainment measures and definitions should be used, as well as appropriate risk adjustment.
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The American Society of Breast Surgeons (ASBrS) supports enrollment of patients into well-designed clinical trials regarding methods to improve the rate of breast-related SSI because reported breast SSI rates are usually higher than other “clean cases.”
- American Society of Breast Surgeons (ASBrS) guidelines:
Rodrigo Arrangoiz MS, MD, FACS a surgical oncologist and is a member of Sociedad Quirúrgica S.C at the America British Cowdray Medical Center in Mexico City:
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He is an expert in the management of breast cancer.
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If you have any questions about the screening for breast cancer please fill free to contact Dr. Arrangoiz.
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Rodrigo Arrangoiz MS, MD, FACS, FSSO 