Assessment of Ethyl Alcohol as Sclerosing Agent in Treatment of Post Mastectomy Seroma

Background: Post-mastectomy seroma is a frequent complication caused by fluid accumulation at the surgical site, delaying recovery and increasing infection risk. Its management is challenging, particularly for persistent cases. Ethyl alcohol sclerotherapy has been introduced as a minimally invasive method to induce fibrosis and cavity obliteration, but its safety and efficacy need further evaluation. This study aimed to assess ethanol as a sclerosing agent in post-mastectomy seromas. Methods: In this prospective interventional study, 39 patients with post-mastectomy seroma underwent ethanol sclerotherapy. A single instillation of 70% ethanol was applied for 15–30 minutes, with repeat sessions if needed. Outcomes included first-session success, number of sessions, total ethanol volume, complications, and recurrence. Results: The mean patient age was 53.9±2.3 years; 69.2% were housewives and 43.6% had comorbidities. First-session success occurred in 61.5%. Outcomes were not affected by age, occupation, marital status, comorbidities, leukocyte count, or albumin. Tumor grade and histology were significant predictors: T1–T2 lesions and lobular carcinoma achieved 100% success, compared with 0% in T3 and 42.3% in invasive ductal carcinoma (p<0.0001). Failures required more sessions and higher ethanol volumes (median 400cc vs. 100cc; p<0.0001). Complications were rare (infection 10.3%, no flap necrosis). Recurrence was 15.4%, linked to lower albumin, lower leukocyte count, higher ethanol volume, and T3 grade (all p<0.05). Conclusions: Ethanol sclerotherapy is a safe and effective first-line treatment for post-mastectomy seromas, especially in patients with smaller cavities (T1–T2) and lobular histology.