Possible Breast Lymphedema

AbscessMomma

I hope you kind ladies will allow me to stay.  I am not a breast cancer patient, however I did have surgery to remove a very large breast abscess (8cm*10cm) 2 months ago.  Unfortunately, there is not much information out there about complications that can arise after a breast abscess incision and drainage.  And the few ladies who I have spoken to who had breast abscesses report no further complications once the incision healed.  Therefore I seem to have to come to breast cancer forums to get any relevant information.

My story: (I'll try to keep this short.  )  Shortly after I began nursing my daughter I formed a grapefruit sized mass in my left breast.  I was being treated for mastitis, but the mass quickly grew in size.  It was one of the most painful things I have ever experienced and I lost the ability to nurse my daughter due to the significant swelling.  After a trip to the ER, I was sent to a breast surgeon who specializes in breast cancer surgery.  After an ultrasound, fortunately (that it was not agressive cancer) it was found to be an abscess and it was surgically drained.  The BS had to make a very large incision due to the size and amount of fluid in the cavity.  The wound was packed the gauze and left open.

The hole finally closed about 3.5 weeks later.  About a week after that I began developing worsening breast pain, swelling, skin/areola/nipple thickening, a dimpled/enlarged pores look to half the skin on my breast, redness, burning/tingling/pricking of the thickened skin, etc.  (Symptoms re near the bottom right of my breast...cut was made at the top left.)  A google search of these symptoms sent me back to the surgeon in a panic questioning whether my symptoms could be IBC.  They performed a mammo and ultrasound, and both were clear other than some scattered calcifications, which my BS didn't seem alarmed by.

The BS told me that he had to cut through some of my lymphatic ducts and my symptoms were "expected".  (They had to cut almost 1.5 inches deep/2 inches wide to get to the abscess.)  He was very confident that there was no sign of IBC.

It is now 4 weeks after my last visit with him and now I am experiencing the same breast symptoms as well as chest pressure, sharp pains into my shoulder blade, a full feeling in my armpit and inside of my arm (neither are visibly swollen), and shoulder and neck tightness.

After all that, my question is, can this be lymphedema from damaged lymphatic ducts?  I feel like my symptoms are almost extreme seeing as how I have not had nodes removed, as some of you have.  I do have a mass of scar tissue under my scar.  I am still trying to nurse my daughter from the affected side, but it is extremely uncomfortable due to the continued nipple/skin thickening and swelling.  (I'm sure the milk in my breast putting pressure on everything isn't helping either.)  Should I have a consultation with a lymphedema specialist to see if that is what I'm experiencing?  I just want to nurse my daughter again without pain!

Sorry for my rambling and intruding on your forum, but I would greatly appreciate any advice from you kind ladies!! 

purple32

Hi There Momma

Let me start by saying what I most confident in ...you are more than welcome on the forum!

Until someone with more knowledge pops in ( I'm fairly new to this )  common sense tells me I would stop nursing at least for  a few days  and see how things go.

After that, if things did not improve,  it wouldnt hurt to have  a consult.

I think LE in  your situation would be uncommon, but not totally impossible.

I have  a feeling you'll be fine.

Take Care....others will come with more info soon, I am sure !

Binney4

Welcome, Momma! So glad you found us, and I hope we can all be of help and support in your very difficult situation.

I'd insist on a referral from any of your doctors to a well-qualified lymphedema therapist. Both the severity of the surgery and the fact that there's a lot of scar tissue would indicate that an evaluation for lymphedema is a very reasonable next step. Don't wait. Symptoms of breast lymphedema definitely include peau d'orange skin changes as you've described, and lymphedema affects the entire quadrant--consequently the "full" feeling in armpit, arm and shoulder. Here's how to find a well-trained lymphedema therapist near you:
http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm
Be sure to call first and ask about their experience with breast lymphedema (it is actually called "truncal lymphedema")

Here's information about truncal (breast/chest) lymphedema:
http://www.stepup-speakout.org/breast_chest_trunckal_lymphedema.htm

Prompt diagnosis and treatment makes lymphedema much easier to treat and control, so please do get to a therapist soon. Our doctors (especially surgeons) really do not know much about truncal LE and can be really slow to recognize it, or even unsure where to send you for evaluation, so plan to advocate for yourself on this.

I'm not sure stopping nursing would be a great idea, as it will engorge the breast further, and if your lymph system is already blocked and compromised that sure isn't going to help, as it will put pressure on the delicate lymph vessels. But I'm not sure about that. Best to get to a therapist as soon as possible and ask her for help with that.

Please keep us posted, and let us know how we can help!
Gentle hugs,
Binney

purple32

I'm not sure stopping nursing would be a great idea, as it will engorge the breast further,

I told you someone with more knowledge would hop in soon!
Good luck to you!