Hematoma after lumpectomy

Bella2018

Hello dear friends,

I got stage 1 breast cancer(Invasive DCIS stage 1) on my right side breast, and got lumpectomy on Sep 20th with sentinel node removal(for biopsy)

Everything went well and I felt great from day one.

My tumor was about 2 inches outside nipple towards the armpit. My surgeon made only one incision one inch further towards the armpit with a length of 2 inches. I guess he used that same opening to remove the tumor and also the sentinel node.

But since day one it was very swollen and huge bruise(red/black) all over my right(outside) half of my right breast and started to coming down towards my waist over my surgical bra they have me to put on. I thought it was normal just after surgery.

Day 2, just before noon, I got a call from surgical center's nurse asking how I was doing. I told her I'm doing pretty good, slept well, eating well, no nausea, no fever, nothing except it's swollen almost double size and the bruise seems getting bigger and spreads toward my waist, and also towards inward which means the other half of my right breast. And they are very red and black.

The nurse from surgical center told me it could be in a normal range but sound a bit too big so I should notify my Surgeon's office while she'll leave a note to them too. I called right away the Surgeon's office. A admin staff answers and saying even without me finishing all my phrase, 'it is very normal after surgery' Then I had to insist, I hope to thing so too, but I am just calling because the surgical center nurse asked me to do so. Then the admin staff said she'll 'email' surgeon's nurse to give me a call. That was Friday 12:15pm and I didn't get any phone call back.

In the meantime, I was filling out daily questionnaires on the hospital's portal as requested. And after the weekend finally got a call from the nurse of the surgeon's office. She was telling me the same thing that it is very normal to have swollen breast and some bruise. But I told her I understand but up to what size of swollen breast and bruise is normal? I am not an expert to judge if it's normal or not. Then she was asking if it's as hard as baseball. Well, definitely it feels very hard, but not up to the level of baseball I replied. She asked me to send photos of mu breast over the hospital's portal. I did. Then the surgeon himself called me in the afternoon, saying hematoma is very common thing and he saw my pictures it looks a bit big but nothing to worry about. It'll go away in 2 weeks or so. So I was very relieved. But after I hung up the phone, I started to worry about what the nurse was asking. 'Is it as hard as baseball?' What if it is? And how do I know if it's hard enough(?) to worry about? And how does the surgeon know just by looking at the photo that it is not hard enough(?!)? So I called the office asking I'd like to visit to show the doctor to examine it. The nurse was again telling me the same story saying "We'd be happy to have you visit, but it is really nothing to worry about and they are very common thing after a lumpectomy' BTW, by that time my bruise was still same color but got bigger area almost touching my right side belt line and also one third of my left breast.

As you all know, for breast cancer, preventing reoccurrence is one of the key things and that's why all those radiation therapy(RT), chemo, hormone etc. And after a lumpectomy you need around 4 weeks of healing time before you start radiation therapy to make sure the surgery wounds are well healed. But I have huge bloods traveling around my cancer breast towards clean torso up to waist and towards the clean breast. Are these going to spread any possible left-over-cancer-cells? And if the huge area of red/black bruise is not completely reabsorbed, will I have to start radio therapy later than normal to wait it goes away completely? If RT starts as normal over bruised skin, will it affect the effectiveness of RT? Is hematoma(big bruise insdie) makes surgical wound healing procedure slow? Will RT have more possible side effect on the skin if there's bruise?

With all those questions in mind, I finally got to see my surgeon(against the nurse's will) on day 6. In the very morning after I took very quick luke warm shower when I never put shower stream directly on my breast, I found a couple of drops blood at the bottom end of the incision where it was glued at the surgery so they told me I can take shower as normal after 24 hours. While that shower of that morning was my second one, since I wanted to preserve the surgery area and glue as intact as possible. I was not putting water in the breast area. When I met the doctor the first word he said after seeing my breast was "Hmmmm, yes there's hematoma, I need to bring some needles but nothing to worry about"

Well, when he says different things from two days ago while my breast looks almost same, it was worrisome.

He brought in some kind of needle( I didn't dare to look) and poked inside my breast through the bottom point of my incision. He said it can be a bit uncomfortable. But to my surprise, I didn't even feel it. I told him and he said 'perfect'. During the needle goes in and out, huge bloods were pumped out I didn't feel anything. It was good that it was not hurting at all, but at the same time it was scary. Is it normal that you feel completely numb around surgical area after a week? And the sense will come back soon?

He told me my sentinel node area looks very good but maybe some blood vessel were not completely closed during surgery on the tumor area. BUt he thinks it'll go away. But if not we'll have to do another surgery. Wow, that's something to worry about.

One thing I was wondering since the day one, was why there's no draining tube/poche after surgery?

When I was reading many articles here, it seems many people got draining device even after stage 1 lumpectomy.

Would it be an accident that they didn't close well some of the blood vessels? And didn't put a draining device? And neglecting and blocking me who reported the swollen breast with huge red/black bruise which grows since day2?

Thank you so much to have read my long story, didn't know how to reduce and I thought it was worth to explain all details.

Looking forward to some enlightenment from fellow fighters!

Love,

Bella

gb2115

Hi Bella2018--welcome to BCO! Sorry to hear of your issues after lumpectomy. Sounds like your surgeon is taking care of your hematoma. Hematoma is one of the risks of having lumpectomy. It doesn't necessarily mean that anyone made a mistake. I had a huge hematoma after an MRI biopsy, it just kind of happened. They had trouble getting me to stop bleeding initially---stabilized me and sent me home, and then it opened back up inside and started bleeding. It was hard as a baseball like you described. I was able to have lumpectomy, during which they tried to drain the hematoma but couldn't (it was already solidifying)--and I had that huge hematom until about halfway through radiation when it started dissolving. Your radiation oncologist will assess you and decide whether or not to delay radiation. Mine wasn't delayed, and my hematoma was sizeable. I imagine it depends on the location and whether or not they think your breast will shrink significantly. I was worried at the time and surveyed the available literature and learned that they are ok waiting up until about 12 weeks (I think, might have been longer but I really can't remember)--so if you do need to wait a bit for them to start radiation don't worry too much about it. They will start radiation even if you're seriously bruised from surgery---the radiation beams can go through something like that.

As far as the drains go, I don't think it's normal to get a drain put in after lumpectomy---that's for mastectomies. I didn't have a drain. Hematomas are not typical, but some women can develop something called a seroma, which is fluid built up in the surgical cavity. That is normal and will reabsorb over time. I've heard of some having to go get that drained. I had some in there, but it reabsorbed.

I imagine you'll feel better after you see your radiation oncologist. They should be able to alleviate some of these fears.

Hope you feel better soon!

Bella2018

Thank you so much for your kind post gb2115!

And thanks for sharing your experience! Already I feel a bit better that I am not alone! And great to hear that your case was before the lumpectomy so you didn't have to go through second surgery for that. I don't know if my case was seroma too, but when the doctor put the needle inside my breast it went in quite deep and pumped out a lot of blood so maybe my hematoma formed some seroma somewhere?! Anyway I am going to see the surgeon tomorrow morning so I'll see what he says and if he'll need to drain again from my re-swollen breast. I have my radiation oncologist meeting set up on Oc 4th(earlier I insisted to meet RO that day so I can have a bigger picture in advance).

BTW, reading your cancer description, I see you are on hormone therapy without chemo, how long did it take for you to get the Oncotype DX result from your surgery date?

Thanks again for your post and wish you all the best for the rest of your treatment!

Love,

Bella