Red Breast Syndrome: A Review of Available Literature

Aesth Plast Surg (2015) 39:227230 DOI 10.1007/s00266-014-0444-x

REVIEW BREAST

Red Breast Syndrome: A Review of Available Literature

Peter S. Wu Sebastian Winocour

Steven R. Jacobson

Received: 27 November 2014 / Accepted: 20 December 2014 / Published online: 22 January 2015 Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2015

Abstract There is scant literature regarding a recently identied clinical entity termed red breast syndrome. Its clinical presentation has been described as a non-infectious, self-limited erythema of a post-mastectomy breast reconstructed using acellular dermal matrix. Its incidence, risk factors, pathophysiology, clinical course, management, and long-term sequelae are largely unknown. We present a review of the available literature on this phenomenon and highlight some opportunities for further research.

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Keywords Red breast syndrome Breast erythema

Acellular dermal matrix Breast reconstruction

Breast implant

Introduction

Red breast syndrome (RBS) is a recently identied clinical entity characterized by non-infectious erythema associated with the use of acellular dermal matrix (ADM) after post-mastectomy reconstruction. The term red breast

syndrome rst appeared in the literature in 2010 in a correspondence between Newman et al. [1] and Nahabedian [2]. Since then, a paucity of research has included RBS as an outcome measure but no studies have addressed this phenomenon directly. Little is known regarding its incidence, risk factors, pathophysiology, clinical course, management, and long-term effects. All of these areas merit further scientic study.

Presentation, Diagnosis, and Clinical Course

Newman et al. [1] and Nahabedian [2, 3] commented on their experience with a syndrome of blanching erythema of the reconstructed breast without local signs of infection. Even so, distinguishing RBS from cellulitis remains a diagnostic challenge; the clinical differences may be subtle. The distribution of the erythema found in RBS was described as being localized over areas where the ADM was placed (typically along the inferior breast), and the phenomenon occurs days to weeks following the procedure. The erythema typically resolves within a few weeks or months without treatment. The degree and distribution of ADM incorporation may...