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Introduction: Chest X-rays (CXRs) are performed routinely as part of staging of primary breast cancer patients in most breast units in Denmark. However, several international studies have found exceedingly low detection rates for occult pulmonary metastatic disease among breast cancer patients. Even so, no data have previously been published on Danish patients., Methods: A retrospective study was conducted of all breast cancer patients undergoing CXRs at the Department of Breast Surgery, Herlev Hospital, from April 2016 to December 2017. The primary outcome was detection of pulmonary metastases on CXRs at the time of the patient's breast cancer diagnosis. The follow-up period was 12 months., Results: A total of 1,014 patients were included in this study. Among these, 11 (1%) had a positive CXR and 1,003 (99%) had a negative CXR. Three (0.3%) patients were diagnosed with lung metastases but had false negative CXRs. The sensitivity was 0%, the specificity was 98.9%, the positive predictive value was 0% and the negative predictive value was 99.6%., Conclusion: Routine preoperative CXR did not impact staging or lead to changes in the treatment of breast cancer patients. Therefore, routine CXR cannot be justified and should be omitted., Funding: none., Trial Registration: The study was approved by the local hospital legal department (Herlev and Gentofte Hospital) as quality assurance research (workzone number: 19000557)., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)

Introduction: This study served the following three purposes: To evaluate the prophylactic effect against seroma of a single dose of steroid in the mastectomy cavity, to evaluate the thesis that there is a connection between subclinical bacterial colonization and seroma formation and to evaluate if a simple urine stix test can detect postmastectomy infection., Material and Methods: This was a double-blinded and randomized study of injection of methylprednisolonacetate versus saline in the mastectomy cavity at the time of drain removal. A total of 160 females were enrolled after mastectomy. The study parameters were as follows: seroma volume, number of seroma punctures, frequency of clinical infections, degree and type of subclinical colonization, complications and evaluation of the microbiological results of the stix test with automatically read glucose, ketones, blood, pH, protein, nitrite and leucocytes. The degree of inflammation was monitored by measurement of 15 cytokines in each sample of seroma fluid. The study was initiated in August 2010 and is expected to run for three years., Discussion: Some reports have concluded that seroma formation forms part of postsurgical inflammation. Steroids are effective against inflammation and accumulation of fluid at the surgical site after several types of surgery and have also proved valuable in the treatment of seroma formation. In the present study, the prophylactic effect of steroids on seroma formation is investigated., Conclusion: As the incidence of postmastectomy seroma formation is 80%, there is a need for improvement in the prophylaxis and treatment of this condition., Funding: not relevant., Trial Registration: Medicines Agency The EudraCT number 2009-016650-40 has been issued for your Sponsor's Protocol Code Number 23837. Data protection agency J.no. F.750.75-2. The study is perfomed in collaboration with the GCP Unit, capital Region, Bispebjerg Hospital under the EudraCT number: 2009-016650-40.

Introduction: Seroma formation is a common problem after breast surgery. Studies indicate that seroma formation is a result of the postoperative inflammatory process. Glucocorticoid inhibits the inflammatory response., Material and Methods: In a randomized pilot study, we measured the effect of glucocorticoid on drainage volume and seroma formation after breast surgery. A total of 42 patients with operable primary breast cancer scheduled for total mastectomy were randomized to either 125 mg methylprednisolone sodium succinate intravenously as a single bolus before the start of surgery or to a control group., Results: There was no difference between the groups as to the number of patients having drains from day to day. The drainage volume was lower in the methylprednisolone sodium succinate group than in the control group; however, the difference was not significant (7,979 ml versus 9,267 ml). There was a tendency towards a higher seroma formation in the methylprednisolone sodium succinate group, but the tendency was not significant (15,803 versus 13,987 ml), and there was no significant difference in the number of seroma aspirations after surgery (92 versus 99)., Conclusion: Injection of a bolus of 125 mg of methylprednisolone sodium succinate before mastectomy did not reduce drainage volume or seroma formation. If intravenous glucocorticoid did have an effect, the case material was too small to prove it.