Electrosurgical Bipolar Systems Versus Conventional Electrocautery After SLNBx

The efficacy of electrosurgical bipolar systems in axillary lymph node dissection for breast cancer surgery is well known. In this study, the investigators aim to determine whether using electrosurgical bipolar systems helps reduce seroma formation in high-risk patients undergoing sentinel lymph node biopsy (SLNB) for breast cancer surgery. The investigators will focus on patients who are expected to experience high drainage output after SLNB, especially those who are obese (BMI\>25) or have undergone preoperative chemotherapy.

Sex

Female

Minimum age

20 Years

Maximum age

80 Years

Inclusion Criteria:

* Women aged 20-80
* Candidates for breast-conserving surgery and axillary sentinel lymph node biopsy
* BMI over 25 or those who have received preoperative chemotherapy
* Overall performance status of Eastern Cooperative Oncology Group (ECOG) 0-2
* Participants who understand the study contents and can provide written consent
* Participants without evidence of distant metastasis

Exclusion Criteria:

* Those with suspected axillary lymph node enlargement or metastasis on preoperative imaging (breast MRI, chest CT, breast ultrasound)
* Among patients who had confirmed lymph node metastasis before neoadjuvant chemotherapy, whose preopreative image showed residual disease at axillary lymph node
* Those planning for mastectomy
* Those planning for axillary lymph node dissection without SLNBx
* Male breast cancer patients
* Patients with bilateral breast cancer
* Illiterate individuals, foreigners, or others who cannot read or understand the consent form
* Individuals who voluntarily decide not to participate in the study or do not sign the consent form
* Those judged by the researcher to be inappropriate for participation in this study
* Study participants who did not have a drain inserted in the surgical area
* If the randomized device is not used due to surgical room conditions (e.g., unavailability due to other emergency surgeries, device malfunction) and another device is substituted

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• BACKGROUNDCortadellas T, Cordoba O, Espinosa-Bravo M, Mendoza-Santin C, Rodriguez-Fernandez J, Esgueva A, Alvarez-Vinuesa M, Rubio IT, Xercavins J. Electrothermal bipolar vessel sealing system in axillary dissection: a prospective randomized clinical study. Int J Surg. 2011;9(8):636-40. doi: 10.1016/j.ijsu.2011.08.002. Epub 2011 Sep 10. PMID 21925293
• BACKGROUNDMiyagi K, Rossi SH, Malata CM, Forouhi P. Novel use of LigaSure Impact electrosurgical bipolar vessel sealing system in skin-sparing mastectomy. J Plast Reconstr Aesthet Surg. 2015 Jun;68(6):e126-8. doi: 10.1016/j.bjps.2015.01.005. Epub 2015 Jan 26. No abstract available. PMID 25682592
• BACKGROUNDPark HS, Lee J, Kim JY, Park JM, Kwon Y. A Prospective Randomized Study to Compare Postoperative Drainage After Mastectomy Using Electrosurgical Bipolar Systems and Conventional Electro-Cautery. J Breast Cancer. 2022 Aug;25(4):307-317. doi: 10.4048/jbc.2022.25.e29. Epub 2022 Jun 27. PMID 35914746