A Swollen Pocket After Breast-Cancer Surgery? Could Be a Seroma
It’s like a blister, puffy and uncomfortable, that may form after you’ve had a mastectomy. In fact, it’s the most frequent postoperative complication after breast-cancer surgery, especially if the lymph glands in the armpit were removed. It’s called a “seroma,” a nice-sounding name for a condition that can cause discomfort, pain, and extended hospital stays.
“I had a bilateral mastectomy last week and came home with drains on both sides,” says fighter Louise414. “Shortly thereafter the drain on the right side stopped working. I saw the surgeon again thinking he would somehow fix the drain. Instead he removed it. I immediately developed seroma.”
Basically, a seroma is a collection of clear fluid (usually blood serum or blood plasma) under the skin. Drains are used post-mastectomy to dispose of the fluids that typically gather after surgery, but once these are removed, some fluid may still pool up in places like the surgery site, under the armpit, and even in the shoulder area, if muscle was removed to help in breast reconstruction. According to BreastCancer.org, they can show up 7–10 days after surgery, typically after the drainage tubes have been removed.
If the seroma isn’t causing you too much discomfort, it will usually absorb back into the body in about a month, though sometimes it can take much longer. If it is painful, you can go to your doctor to have it drained (much like you might drain a blister) with a needle and a syringe, though this can carry a slight risk of infection. Sometimes, you may have to have it drained more than once, or the doctor may use medications to help encourage the body to absorb the fluid.
Researchers have been studying seromas to try to find ways to reduce or eliminate them after surgery, but so far haven’t had a lot of luck. One study published in the World Journal of Surgical Oncology (December 9, 2004) concluded that it didn’t really matter when drains were removed, what type of dressings were used, how often the arm was moved, how old the patient was, what the status was of the lymph nodes, or how large the tumors were. They did find, however, that there was a 2.5 times higher risk of seroma in patients who underwent modified radical mastectomy as opposed to breast preservation.
A current clinical trial begun in 2006 is exploring the use of steroids (i.e., glucocorticoid) after surgery to help prevent seromas from forming. Surmising that seroma formation is the result of inflammation, researchers wonder if substances that decrease inflammation might decrease the chance of seroma formation as well.
If you notice a swollen, tender area developing after your breast-cancer surgery—that feels like a pocket of fluid or hard like a lump underneath—check with your doctor, but don’t panic. It could very well be a seroma. Fighter Becky says, “I am three weeks out from a radical mastectomy and thought I had injured myself by doing too much too soon. Knowing that the seroma is a normal by-product of the surgery is very helpful. It is certainly uncomfortable, but knowing that it is a common occurrence makes it less scary.”
If the fluid seems to be increasing, the seroma getting larger, or if you’re experiencing pressure on the healing area, see your doctor. If you do have it drained, watch for signs of infection, like redness, warmth, or tenderness.
Have you had to deal with seromas after surgery? How did you deal with it?
Photo courtesy jogya via Flickr.com.
I have been drained twice since my surgery almost 4 months ago and I can feel the fluid building again. Not sure what to do; it is frustrating and depressing….I only hope that it will eventually stop and I will be okay.
Hi, Chris. I’m sure that is depressing—anyone would think so. Can you check with another doctor? Sometimes a fresh eye on the problem can be a good way to find a permanent solution. I understand that sometimes it can take up to a year, however, for some surgical swellings to disappear completely, so try to be patient with it and take care of yourself. The body seems to heal on its own timeline and often that is much slower than we would like. Best of luck to you and be kind to yourself.
Bilateral Mastectomy on February 11, 2013. Drainage tubes removed Feb 18. Fluid buildup on right side very painful. Has since had over 500ccs of fluid drained over the past three weeks by my doctor with needle and syringe. Hopefully yesterday 3/7/13 was the last of it. Its very frustrating and depressing especially when the left side is the cancerous side(left) and has not had any problems with fluid buildup.
Hi, Katrina. I’m very sorry to hear about the swelling you’re suffering. I don’t know if it helps, but it is something I’ve heard many other survivors talk about after mastectomy, so it’s something that often happens. In other words, you’re not alone. Sometimes the body just needs more time to absorb that fluid, and it takes longer to do it than we’d like. Watch the area carefully, and if you see redness or develop a fever, check with your doctor right away, as that could indicate infection.
In addition to the helpful hints in the post you read, you may want to look into some natural remedies that help with swelling. These include quercetin, bromelain, and gotu kola supplements, as well as ginger tea. Meanwhile, try to be patient and take good care of yourself—this will eventually pass!