In January of 2008 I had a lumpectomy done and then received chemo from Feb 1st to April1 (total 4 treatments three weeks apart). My radiation followed and was completed by July1st (36 treatments). Two weeks after my lumpectomy on my right breast I developed severe swelling of the right breast with redness of the skin and my surgeon called it a seroma. The surgeon attempted to aspirate it, but decided to send me to the Breast Cancer Center to have it drained under ultrasound. Consequently, they drained almost 600cc the first time! Unfortunatley, the fluid recurred and they recommended drainage again. The surgeon would put me on antibiotics, then send me to the Breast Center for drainage of the seroma. After three episodes of draining the right breast, the surgeon sent me to an Infectious Disease Dr who had no further suggestions or comments. I still continue to have swelling, considerable amount and resulting pain constantly. When I saw the surgeon in August she said I have lymphedema and basically will have to live with it. So, my question is, are seromas common after a simple lumpectomy and why do they occur? And now they are saying it is lymphedema. What is the difference between lymphedema and seroma, the causes, and the treatment? I do not have any swelling in my right arm at all and never have had, so I did not think it was ever lymphedema, from what I had read about lymphedema affecting the upper arm. Just my right breast is larger, swollen, harder and firmer to touch and painful. It is quite noticeable with some sweaters and definitely with an evening gown. Is there anything that can be done for the swelling and the pain? Should the surgeon be able to help me with this problem?
Q: Is lymphedema common after a simple lumpectomy and what is the treatment?
Susan, I'm so sorry you're having such troubles! While a seroma and lymphedema involve the same lymph (or serous) fluid, they're somewhat different issues. A seroma develops at the site of the wound - the lumpectomy - as the fluid collects in the area where the tumor was removed, basically filling a now-empty space. As it continues to collect, it makes your breast swell. Why does it collect? Because your lymph nodes wereremoved or damaged, and fluid is leaking from a number of damaged "node connectors" into your breast. Lymphedema, on the other hand, can affect your whole upper quadrant - arm, chest, and back. It, too, is the result of lymph node removal or damage; the lymph system is damaged enough that it just isn't as efficient at moving fluid around as it used to be, and there's a general swelling.
What to do? Can be very problematic, as you've seen. I hate to see them all give up on you; I'd get another opinion. I've heard of women who had chronic seromas, where the solution was an open drain with concurrent heavy antibiotics to ward off infection, until the area finally stops draining. At any rate, even lymphedema is treatable, so I don't think you're getting the best advice. I'd ask your PCP or hospital social worker how to go about getting some help; there's no way you should just accept this as a permanent state, OK? Good luck, and I hope you find some help soon - PJH
Fluid buildup after this kind of surgery is quit common, and has nothing to do with chronic lymphedema, thank goodness. Although if you're on heavy antibiotics, this is more than simple swelling; it's an infection. Unfortunatley, sometimes these infections are quite stubborn; some women find the ultimate solution is an IV antibiotic drip right to the site. All you can really do is continue to drain, and continue with the antibiotics, until the problem abates. I hope that happens soon - PJH
Susan, I'm with PJ. Get another opinion. The doctor who said you have lymphedema might be right. It can affect the trunk as well as arms or legs. And having radiation is a risk factor for lymphedema. However, these days no one should diagnose lymphedema and then tell you that you just have to live with it. Certified lymphedema therapists have a variety of treatments to help with it.
Yes
i also have swelling in my right breast and skin is hard
Hi - There's not enough detail here for me to give you specific help. If you've had a lumpectomy in that breast, you might very well have lymphedema. If you haven't had surgery, you might have an infection; or this might be a cancer symptom. Please see a doctor if this is a new symptom (i.e., not something you've had for years), OK? Good luck - PJH
I am not a Dr, But I had a seroma after lumpectomy. I had 36 radiation treatments, which destroyed some lymph nodes, and the lymph fluid kept leaking in to my breast. I had the fluid removed with a needle aspiration twice. Then I saw a breast surgeon, and he surgically removed the seroma, which had become infected. After the surgery my breast became very swollen and extremely painful. Eventually, 1 week after surgery,my breast was so swollen a small crack opened up, and a huge amount of serous fluid drained out. I was soaked to my waist and around my back. I immediately had much relief from pain. With in another week I was having extreme sharp pains in my breast. Upon my return to the Dr, and after 2weeks of Antibiotics, he started me on elavil 25mg for neuropathy pain. I was amazed that my pain was gone the next day. It is rather sedating, so I take one tablet at night,, My breast is still sore and hard, and I'm to have another ultra sound soon. This will show if I am having any further fluid build up. I have been expiriencing this problem with fluid build up for over a year, and this is the most relief I have had so far. The surgeon siad, if the fluid retuns again, the next step would be mastectomy. I think that if I knew I was to have this much pain, I may have opted for a mastectomy in the first place. But then I am retired, and over the young and cute stage. I'm a great gramma, and a mastectomy would not be an life altering change for me. My comfort is more important. Hope this was helpful to some of you
Linda, I'm sorry you've been through such a painful experience. That's just bad luck, all that swelling that's lasted for such a long time... I'm so glad you've gotten some relief from the Elavil. I hope it does the trick, pain-wise, that your breast finally stops draining, and that you can get back to some semblance of normal soon. Thanks for sharing your experience here - sharing definitely helps other women. Take care- PJH
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I, too, have a problem with fluid in my breast after a "partial mastectomy." I have had it drained by the surgeon once, and only three days later, the build-u p of fluid is oc curring again. The "fluid" looks like motor oil! I will, unfortunately , have to have it drained again undoubtedly and stay on the large-dose antibiotics I am currently on for this. Any suggestions? It's probably seronma. Sonni.