Can seroma in breast increase LE risk?

Options
cider8
cider8 Member Posts: 832
edited June 2014 in Lymphedema

I had Stage 2 DIEP 4 weeks ago and developed a seroma in my cancer side breast.  I had 21 nodes removed.  I'm not understanding a lot about seromas; my nurse warned me they are a case by case thing.  IE: some absorb faster than others, some heal up, some not, some hurt some don't, etc.  Mine drained 210cc last week and I will get it drained again Mon.  I'm making an appt with my LE therapist tomorrow.  I've seen her a few times since I feel heaviness in my arm from first surgery.  No LE.  I'm guessing I need to step up my self massage draining as I'm feeling slight tingling in the arm.  

I keep vacillating between being pissed off and OMG about the seroma, and being not very concerned: it will go away or not, needs to be drained or not.  If seroma increases LE risk, knowing it just might kick my proactive precautions into highest gear.  (I'm still worn out from surgery 4 weeks ago and struggling to get back into regular routine)

· Share on FacebookShare on Twitter

Comments

  • somanywomen
    somanywomen Member Posts: 872
    edited January 2012

    cider8, I believe that you have a point, that possibly having a seroma does influence chance of LE..I have been sore on lump side since surgery over 2 years ago, was told by my surgeon that some people heal slower, no other explaination..I did have a small seroma and it showed up in my scans until recently, you can barely see it...The thing is that this fluid is finally soaked up in the surrounging tissue...

    I just had a second opinion last week with a wonderful female breast surgeon and she does her own ultra-sounds and she actually showed me the areas of my lump tissue that has the extra fluid, it looks different and she thinks that I now have breast LE and that is why I have continued to have the pain for so long..She wrote me a prescription to have and learn a massage technique which I now need to follow-up with...Having a seroma may not be a factor in all LE patients, but I do believe it is the reason for mine...

    · Share on FacebookShare on Twitter
  • kira66715
    kira66715 Member Posts: 4,681
    edited January 2012

    Seroma does increase LE risk, here's an abstract from San Antonio Breast Cancer Conference, and there are other studies:

    http://www.stepup-speakout.org/essential%20informat%20for%20healthcare%20providers.htm

    --Treat seromas promptly: from San Antonio Breast Conference 2010, “Seroma usually leads to prolonged wound healing, tissue inflammation and subsequent fibrosis and necrosis. It has been hypothesized that seroma formation is one of the main risk factors for post-breast cancer lymphedema.”   Seroma Formation Is Associated with Lymphedema-Related Symptoms. 
    http://www.abstracts2view.com/sabcs10/view.php?nu=SABCS10L_478

    It's just a risk factor, but if you're having any symptoms, it would be a really good idea to get assessed by a LE therapist

    Kira

    · Share on FacebookShare on Twitter
  • cider8
    cider8 Member Posts: 832
    edited January 2012

    Thank you Kira.  Not what I wanted to hear (seroma increases risk 3 fold), but best to be informed.  I am increasing my self care.

    Somanywomen, thanks for your experience.   

    · Share on FacebookShare on Twitter
  • somanywomen
    somanywomen Member Posts: 872
    edited January 2012

    Kira, thanks for links, it makes sense that seromas have an infuence in LE...My area of concern and continual pain is in the same area that the seroma was and only in my breast, arm not effected..I had only 2 sentinal nodes tested suppose to have a lower risk of LE, but I don't think enough is known of the cause and how to help those of us prevent it in the first place..

    cider8, I had wanted my seroma drained when I first learned of it, but my surgeon said it was too small to be concerning that it would eventually go away, well it did go away, into my surrounding tissue!!

    · Share on FacebookShare on Twitter
  • cider8
    cider8 Member Posts: 832
    edited January 2012

    Somanywomen, I'm getting drained again Tues and I'm hoping the amount decreases.  I just converted 210cc: it's just over 7 ounces!!  Pretty sizeable.  My PS is out of town, so I think I'm going to send a photo of before and after.  The after draining is startling, though it fills out (not fill up) in an hour or so.  I'm also set up to see my LE therapist.  My tingling has gone away with self massage.  

    · Share on FacebookShare on Twitter
  • Shrek4
    Shrek4 Member Posts: 1,822
    edited January 2012

    I had seroma in the breast (also on the cancer side) and I didn't develop LE. I did have axillary web syndrome though.

    · Share on FacebookShare on Twitter
  • kira66715
    kira66715 Member Posts: 4,681
    edited January 2012

    Day, seromas are so common, and this they tend to be ignored--only aspirated if they're huge or uncomfortable. Seromas in the breast are almost universal--as the surgery leaves a "void" and the body fills it with fluid.

    I work for a rad onc and I see the planning CT's and they can see the lumpectomy site on them, due to scars and some seroma.

    Yet, seromas are a risk for LE--and likely more if they're in the axilla. Nordy once wrote that they can form a "pseudobursa" in the axilla and not allow lymphatics to heal.

    So, they're almost universal--on a subtle level--yet the symptomatic ones should be either treated or the women should be followed closely--per the Mei Fu study.

    The risk calculator for LE, which isn't up on line right now, had seroma listed as a risk. As does the International Best Practices for LE.

    I had a whopper axillary seroma, and if I knew all of this now, when the surgeon asked me "what to do" two weeks post op--I would have had her aspirate it--she finally did 4 months later, and it was pure lymph.

    Kira

    · Share on FacebookShare on Twitter
  • Shrek4
    Shrek4 Member Posts: 1,822
    edited January 2012

    Kira, mine was in the breast itself, the bottom of it, more towards the chestbone and it was quite huge. I kept complaining about it to the PS and he kept saying that it's swelling, until the day when he had to debride my scars and he pulled on a stitch to remove it. The result was about half a quart of liquid exploding on is Armani pinstripe suit. And me, looking at him, standing there drenched and dripping, said with a smug face "I told you so!". I wish I had had a camera to tape the whole thing.

    · Share on FacebookShare on Twitter
  • gsg
    gsg Member Posts: 3,386
    edited January 2012

    kira, i developed a seroma after surgery and 5 years later still have it. for some reason mine has not been absorbed into my system. have not developed LE.  Had it drained one time and it immediately filled back up, so I'm just leaving it alone.

     good luck to you!

     gsg 

    · Share on FacebookShare on Twitter
  • LuvRVing
    LuvRVing Member Posts: 4,516
    edited January 2012

    When my seroma was drained last March, they sent some fluid to the lab and it contained cancer cells.  It had formed in the location of my original biopsy.  I wouldn't mess around with a seroma for many reasons!

    · Share on FacebookShare on Twitter
  • cider8
    cider8 Member Posts: 832
    edited January 2012

    Day!  I have to laugh!  I can't stand how dismissive some Drs can be.  I'm sure he'll never forget about seromas now!!

    Fortunately my labs came back clear.  And fortunately my seroma is not in the axilla.  My Dr office did say that having a seroma from Stage 2 DIEP is unusual.  That breast had a lot of work done though.  I had no healing issues from my BMX, AND and immediate DIEP.  So I am bummed out by this.  The area of the seroma is about the size of my hand and is mostly on the surface (vs a deep pocket).  Ah, the gift that keeps on giving.

    · Share on FacebookShare on Twitter
  • kira66715
    kira66715 Member Posts: 4,681
    edited January 2012

    Day, that is a great story about the seroma and the Armani suit!

    There was a thread when the abstract came out and I bumped it.

    Kira

    · Share on FacebookShare on Twitter
  • cider8
    cider8 Member Posts: 832
    edited February 2012

    I thought I'd update how I'm doing.  So I had the seroma aspirated 3 times: 210cc the first time, then 140cc and 79cc.  Since the last aspiration Jan 26 I've been treated by my LE therapist.  She's treating my breast with a cold laser to try to speed up what manual work would do.  She's doing the MLD on my arm, neck chest ribcage belly, and myofacial release on the breast.  The tissue in my breast is getting firm (ugh!), so she's trying to soften up for both lymphatic flow and to have a 'normal' squishy breast.  I feel almost no heaviness in my arm now, so I feel like my whole self is being treated.  It might even be no heaviness: I'm still trying to understand signals/lack of signals from the numb area of my arm.  I'll continue with my LE therapist for a few more weeks to see if the seroma goes away completely, to see if I want it aspirated.

    Thanks so much for all the feedback here!  It helps me plow through getting the best treatment I can. 

    I wanted to add that my lingering fatigue is explained by my very recent hypothyroidism diagnosis.  The gift that keeps on giving!! 

    Oh, yes, one more edit.  My LE therapist taped my breast for the weekend.  Kinesio tape I think it's called?  With the 'fingers.'  Just trying to get that fluid to flow to the center of my chest. 

    · Share on FacebookShare on Twitter

Categories