Cording in breast itself?

Aruba

Hi all, I had a lumpectomy (at 12:00 postion) of left breast along with SNB with one node only taken on left side 3 weeks ago today.  Had no soreness from breast incision and a bit of soreness that went away from snb incision.  But the soreness on left side of breast has gotten more tender and now hurts.  I only took one percoset night of surgery and nothing since so pain was nothing till now.  I keep pushing on left side of breast and when I lifted my hands above head (no problem with ROM) i noticed what seemed like a slight line going down left side of breast.  Today after work, I just felt around a bit and feel what I think is cording going same way as that line.  Can you get cording in the breast inself?  Feels like a big bruise in there but can feel what feels like a rope too.  Can call breast surgeon on Monday but he dismissed me am to see MO for first time on 8/21.  What else can I do or should i take in meantime?  Thanks to all for any advise...

Binney4

Hi, Aruba,

Yes, it's possible to get cording in or under your breast. It's called a Mondor's cord, and it can happen after any breast surgery. Here are some pictures/explanations of Mondors after breast augmentation:
http://dr-dowden.com/faqs/implmond.html

Gentle stretching might help, or better yet get a referral from any one of your doctors to an experienced lymphedema therapist for help (call ahead and sound them out on their experience with cording). Here's how to find a well-trained therapist near you:
http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm

And here's information specific to cording:
http://www.stepup-speakout.org/Cording_and_Axillary_Web_Syndrome.htm

Hopefully others will be along before long with experiences to share.

Gentle hugs!
Binney

Aruba

Thanks so much for the quick reply Binney!  I have a feeling this is it although those pics on the site make it look like they are visable and mine feels below the skin.  Funny that the Dr. named on the 1st website is in Cleveland..as am I.   Will put in a call to Dr. on Monday.  WOnder if advil is good to take...and if Ice pack or warmth is better for weekend.  OUCH!!  Thanks.

LindaLou53

Hi Aruba,

Cording is possible in the truncal area post lumpectomy or mastectomy.  There is a type of cording called "Mondors" which is described as involving the superficial blood vessels in the trunk/chest area, as opposed to Axillary Web Syndrome which is defined as affecting the lymphatic vessels in the axilla and down the arm.  Honestly, I would like to know how one can clinically determine whether cording involves blood vessels, lymphatic vessels or both.  The presentation and symptoms of both Mondors and Axillary Web are very similar other than Mondors usually refers to the breast/trunk area and AWS the axilla and arm.

The symptoms you are experiencing could be related to many things.  You are only 3 weeks out from the Lumpectomy/SNB and some amount of soreness/tenderness is expected.  I know what you describe seems to be an increased amount of discomfort, however, so it should be monitored.  It is possible to develop areas of seroma around the lumpectomy site, fatty necrosis can also develop which can be a notably different texture and firm feeling area in or around the breast along with tenderness.  One other potential irritant to keep in mind, since I know most of us have done the very same thing when we find an area of concern, is we can aggravate any tenderness ourselves by constantly pushing, palpating, and poking the area many times a day.

I had Mondors cording develop 5 months following my lumpectomy, in which I felt a definite firm "rope" running from underneath my breast, down my ribcage and towards my waist.  It was tender, it hurt to raise my arms over my head and it lasted for more than 2 months.  My onc told me rest, cool packs and NSAIDS such as ibuprofen would help. Following my bilateral mastectomy I developed cording again, this time on my left chest wall/ribcage below an area of seroma.  I also had Axillary Web Syndrome with cording down my arm to my wrist area.  Again, my surgeon felt it was a superficial phlebitis of the blood veins, however, I believe it also had to involve the lymphatic structures.

Standard treatment for phlebitis involves rest and comfort measures, but typically they do not prescribe PT ROM or tissue work.  Axillary Web and Lymphatic cording, however, can certainly benefit from a trained PT who understands working with post-op cancer patients.  Gently stretching those areas of cording and supporting the lymphatic drainage with MLD can help reduce the chance of developing lymphedema following an episode of cording.  There is a great article here on the details of Axillary Web Syndrome:

http://www.stepup-speakout.org/Cording_and_Axillary_Web_Syndrome.htm

Aruba, your presentation of tenderness and mild detection of what could possibly be a cord in your left breast may not be Mondors or Axillary Web either one, but it should be checked out.  Especially since you are only 3 weeks post-op I would still contact your surgeon on Monday and try to get in and see him for evaluation.  It is not at all unusual to develop post-operative seromas or fatty necrosis.  If he does not feel you are dealing with seroma, hematoma, fatty necrosis, infection etc., ask him for a referral to a lymphedema therapist for eval and treatment. Try not to examine the area excessively yourself, although I know that is hard not to do. Be observant if you see any spreading redness or increased heat in that area of your breast.  You don't want to delay in seeing a medical professional if you believe you have an early infection developing.

Good luck and let us know how it goes!

Aruba

I am so grateful to have this site and have found great sources of information!!  I had my more compression like surgery bra on at work today but came home and let the girls out  and did my gentle check.  Hubby came home and had him stand behind and check without looking as well and can feel that cord like feeling.  Just a weird place to present..with no presentation on skin surface but underneath.  Just took at motrin and have a warm pack on it...reminds me of a hemmoroid..but in breast.    I'll call Breast surgeon on Monday.  Figures I went to work 4 days after surgery feeling fine...awaiting that Oncotype (had insurance glitch now stating MO had to request not BS (what??) as MO would be directing treatment.  So one step at time.  THANK YOU...THANK YOU...  I can already tell that now when anything is up..fear sets in quickly.....

Aruba

To update went back to BS today The line/indentation on lest side of breast starting at end of snb incision is mondor's cord. Heat and motrin and he says pain should go away but still may feel cord. Could take a few weeks. Asked if this any precursor to lymphedema. He strongly said no. Meet MO first time next week for onco score and will tell her about mondor. Could chemo or rads make this worse??