Crater in breast after infection

Lisachocoholic

Dont know where to post this. Stage 1 was first diagnosed as stage2a but downgraded after lumpecomy found tumor was 1.9 instead of 2.0 cm. HER2 positive. Only had sentinal node removed. Had lumpectomy August 2018, started chemo and Herceptin September, them a re- excision in November. Just had final chemo yesterday February 26 2019.

Last week what I thought was an infection deveioped at the smaller incision scar. Oncologist said yes its infected and prescribed Levofloxacin for 10 days. Meanwhile it has been draining more and more, a clear but slightly yellow fluid with a tinge of blood. Been wearing nursing pads continuously the past week.

Tonight I was shocked to see the area infected has collapsed and there is now a crater in that area! It's like the area was only fluids and so much has drained now that there's no tissue there and it's just an empty space in my breast. Has anyone experienced a crater in their breast? Does this sound normal?

I am also fighting car problems and legal problems and my doctor is 60 miles round trip so I'm trying to avoid as much driving as possible (car broke down twice past 8 months) and the legal stuff is due to the death of my ex-husband and I am extremely stressed out every day, which has made mental healing impossible, and probably affecting physical healing.

So what do you think of breast craters?

Oh also I called surgeon twice and he blew me off. He too is a 60 mile trip.

Mucki1991

Hey I

m sorry your going through a crappy time right now. The crater does not sound abnormal after an infection. I do not have experience with that issue but I can tell that it can be fixed with fat grafting. After my breast surgeon did his thing he went MIA lol I would suggest you start shopping for a plastic surgeon so you can have the defect corrected.

Best wishes!!!

vlnrph

Oh dear Lisa, that is a lot to be handling right now. Maybe there is a generous friend who could drive you. One of those people who, when they learn of your diagnosis, say “Let me know what I can do”...

I did not have any infection/abcess causing a large crater, just a couple of ‘dents’ which my plastic surgeon filled in by liposuction from my thighs. That procedure did not reduce my hip area very much although I think there would have been enough there to use for a bigger space! So, fat grafting my be an option for you once eveything has healed. Call around for an MD who can do it if your current team does not have experience in that technique.

Do you have a drain in place or was the fluid coming directly out of the scar? Should you have a primary care provider who is near by (instead of 30 miles away), perhaps that person could check you then call the specialists and get their attention. You might require an additional course of antibiotic treatment.

Lisachocoholic

Hi, thank you for your replies.

I moved to a new town in 2017 after my ex died of pancreatic cancer. I had been living with him for years (yes, an odd arrangement I know) and nursing him after his cancer diagnosis. He only lived 5 months. Anyway, I don't have any friends here but have been paying for rides from an errand service, since the chemo made me feel too dopey to drive.

I don't have a drain. As far as I can see the fluid drains from the smaller scar from the re-excision in November. It is extremely close to the nipple.

My primary physician is nearby and I will see him tomorrow, so even though he's passed treatment on to the oncologist, I'm going to make him look at the crater tomorrow, whether he likes it or not!

I will have to check if my insurance (Affordable Care act) would cover fat grafting. I have tons of fat to spare. That's the almost funny part, I've always been overweight and not even this chemo and surgery has taken a single pound off me. It's like my body is 100% determined to stay fat no matter what!

Would the fat grafting be strictly to return the breast to its former shape? Or is it medically necessary to prevent other problems and/or more infections? Because I could live with the crater if I knew that it was only going to mean an ugly appearance, as long as it doesn't increase the odds of more medical issues.

To be honest, at this point I wonder if I should have had a mastectomy in the first place. My mom died of metastatic breast cancer but I had the BRCA test and I didn't inherit the gene, it was just coincidence we got the same condition. Since there was no hereditary part to worry about, the oncologist encouraged me to go with lumpectomy because it's supposed to be less problems, but that's not my experience so far. Okay enough whining.

vlnrph

Good thing you are going to your primary care doctor before the weekend. I still think he could advocate for you with the surgeon who seems so unconcerned. Afterward, treat yourself to some chocolate!

Interesting that you had the BRCA test instead of your mom. Was that some time ago? Your genetic counselor should know that there are many other gene mutations associated with BC. They could order a broader panel analysis based on your family history.

Fat grafting is often a cosmetic thing. I have a theory regarding our bodies and their ability to stubbornly hang on to every adipose tissue cell available, especially after menopause - that is where our estrogen is manufactured once the ovaries quit working and, being our favorite female hormone, it is beneficial for mood, heart and bone health so we naturally make more of it whenever possible...

Lisachocoholic

Vlnrph, your theory about the cells hanging on makes sense. Rather than calling them adipose maybe we should name them adamant cells

I had the BRCA testing in June or July 2018. They wanted those results before they would recommend which surgery would be best in their opinions.

My mom had mastectomies in 1972 and 1974, in her 40s, and died in 1991 age 63. Obviously treatment then was a different world and that testing didn't exist yet. My father's family history is unknown and there is no other known breast cancer on my mom's side. Early in her 2nd remission from 1980 to 1990 she traveled a lot and in Italy was given a drug not yet allowed in USA- tamoxifen. I firmly believe that drug gave her those 10 extra years she wouldn't have gotten had she remained in-country and not sought out care in a foreign country.