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A Swollen Pocket After Breast-Cancer Surgery? Could Be a Seroma

By Britta Aragon on June 14, 2010 | 8 Comments

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.

Posted in: Side Effects


8 Comments to “A Swollen Pocket After Breast-Cancer Surgery? Could Be a Seroma”

  1. Chris says:

    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.

  2. Britta Aragon says:

    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.

  3. Katrina says:

    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.

  4. Britta Aragon says:

    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!

  5. Debbie says:

    I had a mastectomy Oct 2003 and tram-flap reconstruction Oct 2008, which was worse than the surgery, chemo & radiation all together. It is 2013 and another stich just came out of my fake belly button. NOW, I have an open wound from what appeared to be a boil that developed where I had this hard knot in my stomach. First it started to bruise where the knot was, then the boil and then it started seeping pussy fluid and blood. The knot appears to have shrunk alot though. What is this and should I be concerned?

  6. Britta Aragon says:

    Hi, Debbie. I don’t feel qualified to speak on what you’re experiencing and I would definitely encourage you to talk to your doctor as soon as you can. It’s important not to ignore these things. It may not be anything to worry about it, but you want to be overcautious at this point. Please do have it checked and let us know how you’re doing.

  7. Samantha K says:

    My mom had a lumpectomy in February of this year and also had 5 lymph nodes removed. She developed a knot in her armpit, under her axilla incision, and we were told it was “probably” scar tissue. She had an ultrasound today and we were told it was a seroma. I have had a seroma before, but mine was open (c-section), so I am not sure what to tell her to expect. It didn’t show up until about a month or so ago, and it usually doesn’t cause any problems, but sometimes she has nerve pain and burning in her arm and some swelling too. Can this be from the seroma? How long do those usually take to reabsorb? Mine had to be packed 2-3 times a day for 10wks…Yuck!
    BTW, she will see her surgeon tomorrow.

  8. Britta Aragon says:

    Hi, Samantha. I hope your mom’s surgeon was able to help her. It does sound like the seroma could be connected to the pain and swelling she’s experiencing, though the nerve pain could also be associated with other parts of her treatment. As to how long it may last, it depends on many factors. My suggestion would be to advise your mother to have it drained if necessary. Watch for signs of infection like redness, warmth, and tenderness, and if the swelling increases, check with your doctor. A seroma is an inflammatory reaction, so try anti-inflammatories like fish oil supplements (for the omega-3s), boswelia, ginger, and turmeric. Please let us know how your mom is doing.


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