what to expect *after* Mammosite?

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jd613
jd613 Member Posts: 10
edited June 2014 in Radiation Therapy - Before, During, and After

****argh, browser ate my post, so retyping in a stream-of-consciousness and unorganized manner -- sorry****

I've been a bit absent since my first posts, but I've been reading even when I wasn't posting. I got my IDC/DCIS dx on 2/2 with lots of appts in the 10 days following, until I said the words "I want genetic testing," at which point it all came to a screeching halt until I found out I was (thankfully!) BRCA-. At that point, I scheduled my lumpectomy and SNB for 3/15, then had to wait almost a week to find out (again thankfully!) that I was node negative and had clean margins...then again waited 10 more days after that for my surgical follow-up and evaluation for Mammosite. Once my BS said I had a good cavity for Mammosite, I started the uphill fight with my insurance to cover Mammosite, which was deemed "outside protocol" by my BS since I'm only 41. It took a week, but I got a yes from insurance and got it scheduled. Since my nodes were neg and my OncoDX score was very low, my Med Onc said no chemo for me, yay again! So the ending diagnosis was the best-case scenario for a BC diagnosis...especially considering that the largest axis of my tumor ended up being 1.7 cm.

I did Mammosite from 4/8-14/11 and had the catheter/balloon removed yesterday afternoon.  All week long, I had a very irritated spot on my skin (well it *felt* irritated but didn't look pink to the nurses until after the weekend on day 3 or 4 of treatment) that was about 1/4 to 1/2 from the incision, likely caused by the ring at the end of the catheter. It likely was at the exact spot where there is also a seam on the band of the sports bras I was wearing 24/7. I was fortunate to find some cheap but well-made Fruit of the Loom sports bras at Walmart for $9 each, so I went up 2 band sizes to fit my cup size and hold in the tubes and catheter. I was told to keep wearing these until it was comfortable to go back to my other wireless bra...is it vain to say that I miss my pretty underwire bras and how I looked in them?

Also, my Rad Onc said I only need to wait another day or two before going back to showers, but the nurse who did my steri-strips after the doc finished the balloon removal said that she and the other nurses (as well as the after-care instruction sheet) tell patients to wait.  He's been a little laid-back about things like this, so I am coming here to find out:

      What after-care instructions did other Mammosite patients receive?  And what side effects did you get during or after treatment?

I've read that several women on this boards developed seromas a while after treatment -- did you have a lot of drainage during the week of treatment, and does this relate to whether or not you will develop a seroma? I did drain heavily the first 5 days (incl weekend) both blood and clear fluid, then still enough clear fluid during days 6-8 that the nurses had to change the dressing after both daily treatments; they told me they usually change the dressing in the morning and then just make sure the dressing is re-secured after the afternoon treatment for most Mammosite patients. I even saw a little drainage when I changed the gauze over my incision today.

When did you stop wearing your sports bra 24/7? I'm looking forward to being able to not need one for sleeping!

Also, did any of you experience any skin discoloration? The nurse who did my steri-strips told me that it looked like I was a lucky one as she did see any redness on my breast, but today I think I see some slight-to-medium redness where the balloon had been streching out my skin.

Oy, so many questions I didn't think to ask my RO, and now it's the weekend!

Joanne

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  • BeckySharp
    BeckySharp Member Posts: 935
    edited April 2011

    Joanne, I had five days of mammosite on 2/21-25.  I had a dummy balloon put in on day of surgery 2/14 and traded out for the real thing three days later.  I had enough drainage that it kept leaking through the guaze to my bra which was an annoyance.  The nurse changed my dressing after each am treatment, but I changed myself each evening.  I continue to have slight drainage for about a week and a half after the balloon was removed.  The day the balloon came out I was told not to shower for 48 hours.  The nurse also told me to put a rolled up sock or washcloth between my bra and the incision site for 14 days and to press on it during the day.  She said that would help prevent the formation of seromas and hematomas as it keep air out of the cavity.  It was even written to do that on my discharge orders.  I wore a soft JMS bra 24 hours for four weeks after that.  I saw my team four weeks after the last mammosite treatment and they were really please with my progress.  I hope this helps.  Let me know if you have any more questions.  Becky

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  • LuvRVing
    LuvRVing Member Posts: 4,516
    edited April 2011

    I had Mammosite last summer.  My breast surgeon told me to put the catheter in a zip lock bag so I could shower, which I did.  I made sure it was taped shut and I let the water hit my back rather than my front.  The rad onco nurses would have had fits if they had known.  After my shower, I would re-wrap the catheter to make sure everything was nice and dry.

    I did end up with a seroma in the balloon cavity, but that one never caused a problem. 

    I think I wore a compression bra at night for a couple of weeks because it felt good.  I wore my regular (non-underwire) bras during the day.

    I had no problem with infection, but I was on antibiotics from the day of my lumpectomy until a couple days after finishing Mammosite.  I am diabetic and I think they were extra-cautious with me.  The nurses were shoving mass amounts of Neosporin into the catheter opening twice a day. 

     I had some "dry skin" which showed up about a week after finishing treatment, sort of a delayed reaction.  I also had a bit of esophageal burn, which was not a problem unless I ate something a bit spicy.  It started about the 5th treatment and ended about two weeks afterwards.  I just stayed away from the spicy stuff and didn't need to take anything.

    Michelle

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  • jd613
    jd613 Member Posts: 10
    edited April 2011

    So evidently I can't think and type at the same time...

    1/4 to 1/2 *inch* from the incision is the irritated spot,

    and the Rad Onc's nurse emphatically said to wait another WEEK more until I can shower, but I can do a more thorough sponge bath *if* I cover the gauze with one of those tegaderm plastic patches to keep it water-proof. 

    Also forgot to say that the BS prescribed 10 days of antibiotics (3 pills/day) and told me to take the first dose before he even put in the balloon (that afternoon was day 1, Mammosite started on day 2, today is day 9, so I'll finish up Sunday morning).

    Becky -- Sounds like you drained even more than me; hope that you and I both drained out all of that fluid instead of keeping it in where it could form a seroma. I do have a question about that sock/washcloth idea: did you wear that inside your bra all day long? and how often did you press on it? Also about how to press...my catheter incision was just past the 7 o'clock spot on the outside edge of my right breast where it would hit the bra band and straight down from the front of my shoulder, and the catheter seemed to go forward and up (well, up if I'm in a bra, straight-or-slightly-down if out of a bra letting gravity work) pointing toward my nipple, which is much different from the informational diagrams and video on the Mammosite website. So based on that description and the directions that you received, would I be pushing *up* toward where the balloon was, or would it be better to push *down* from the balloon spot toward the incision to push out the air?  Sorry for the question, but I'm not sure I understood how to apply your description to my situation.

    Oh Michelle, I've been reading some of your posts, and I'm so sorry to hear your first treatment didn't get everything, putting you back into treatment again so soon :( I had read your posts on Mammosite right after my own lumpectomy, and I just saw your news about your BMX this week. I am in awe that you were up and around and out of the house so quickly. I hope the rest of what you are facing, including the move to MA, goes smoothly.  I hate asking about this since it is related to how you found your new tumor...but may I ask you a question related to your seroma? Did you have a lot of drainage during/after Mammosite? and did you do anything like what Becky described above to try to prevent a seroma?

    Thanks again for your replies -- I think I'm just a little paranoid b/c I'm going to be away for the next week, nowhere near my doctors in case anything happened, but this annual trip was planned months ago, BBC,..before breast cancer.

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  • BeckySharp
    BeckySharp Member Posts: 935
    edited April 2011

    Joann,  I rolled up two short socks and kept it in 24 hrs for the 14 days.  I was going to do all I could to prevent a problem!  My incision is under my breast (I am big--a D cup) I guess about 9 am if you are facing me.  It does not go down to the bra band but does hit the side band of the bra.  It said to press in several times a day (I tried to find my discharge orders to type in but have not.  If I do I will give it to you in the exact wording).  So I pressed upward.  From what I recall the nurses conversation she said a hole was made from the removal of the tumor and pressing it together kept it from filling in with fluid.  Plus sometimes it became larger with the hanging of the breast until filled in with scar tissue.  I guess pressing it pushes it together encouraging it to close in.  I did ask if everyone did this.  She said they encourage everyone and that they have fewer seromas and hematomas than other places.  I pressed on it gently.  I do overdo things and was pressing it in probably hourly.  My mammosite catheter was in the crease under my breast at the center.  So my leads and catheter led up into between my breasts.  It kept it easy to wear inside my bra.  But since the catheter hole was down may have been why I had so much drainage.  I had a friend who said hers came out of the top of her breast.  I guess it depends on where the tumor was.  If I find the directions I will put in.  I ended antiobiotic the day I finished mammosite. I was at a cancer center for radiation.  Becky

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  • BeckySharp
    BeckySharp Member Posts: 935
    edited April 2011

    Oh Joanne--something else.  I did not see anyone after my last mammosite treatment for four weeks.  So I would have been able to take a trip.  I did go back to work on the Monday after I finished on Friday.  I just the two weeks off for the surgery and mammosite.  I was just tired for a few weeks and took short naps each day.  B

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  • BeckySharp
    BeckySharp Member Posts: 935
    edited April 2011

    Joann--I did find this where I quoted from my discharge orders and sent to a friend:  

     "To help prevent fluid build-up at the lumpectomy site, place a folded washcloth or rolled up sock inside of your bra at the area of the lumpectomy and apply pressure to the breast at the area.  Do this 3-4 times per day for 10-14 days."   Quoted from MAMMOSITE/Contura CARE AFTER BALLOON REMOVAL   From Radiology Clinic @ Thompson's Cancer Survival Center in Knoxville, TN

    Becky

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  • jd613
    jd613 Member Posts: 10
    edited April 2011

    Knoxville? I'm heading there today!! Small world... :)



    Thank you Becky for all of your help--I'll be visiting my parents, and I'm sure they've got old washcloths in the closet, so I'll grab one there. I'm also a D/DD so I want to try to keep whatever symmetry I can, given that my incision and surgery all happened on the outside edge of my breast.

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  • BeckySharp
    BeckySharp Member Posts: 935
    edited April 2011

    Hey it is a small world.  I live in Jefferson City which  is nearby.  I had my surgery and radiation in Knoxville.  Keep me posted on how it goes.  My skin was okay and not irritated but I had a friend who had some pink discoloration and they put her on a further antiobiotic.  But you are already on.  Take it easy.  You will be tired for awhile.  But I am 63 and you are younger--that may be part of it!

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