Post-Lumpectomy Massive Fluid Leakage and Infection!

Daisey4522 · February 2015

QUESTION: Has anyone ever had infected fluid after surgery? If so, did your doctor drain the area or treat with just antibiotics?

Here are the details of my specific situation.

Friday (1/16): Surgery to remove 2 very large masses (5.6 cm & 4 cm). I was told that the area would fill with fluid and then turn into scar tissue so although the masses are so large, "fluid is our friend" and will help keep me the same cup size, so I would not need reconstruction.
Monday (2/2): Post-Opp Appt, my doctor used his nail to scratch off the glue holding my 2 inch incision together...
Saturday (2/7): I wake up to a horrible smell and my shirt and bed is soaked. I get up and look in the mirror and fluid starts pouring from the incision site (massive amounts at a rapid speed). At first it was yellowish but then it was just red and more clear (w/ a little mucus). My doctor says that there is nothing they can do, to just pad my bra with gauze and that I will be fine and to call the office on Monday to give an update. I asked if I should go on antibiotics and he said that he did not think it was necessary. A few hours later it stops leaking.
Sunday (2/8): It starts to ooze again, but nothing like the previous day. It stops again a few hours later
Monday (2/9): I call the Dr Office and they ask me to make an appointment with one of their nurses to come in so I can be seen. I make the next available appointment (Tuesday).
Tuesday (2/10): I have not leaked since Sunday at this point. I could tell that I had a lot of fluid still left inside of me but the incision site looked good and I was no longer leaking, so the nurse did not see reason to aspirate the fluid or prescribe antibiotics.
Wednesday (2/11): The next day I noticed a yellowish/white cloudy fluid becoming visible between the incision site (on the other side where it had not drained). I called my Doctor's office and told them I really thought I would need antibiotics. The area was swollen, red, painful, and warm to touch. They prescribed antibiotics and I started them Wednesday night.
Thursday (2/12): The next morning massive amounts of pussy fluid started streaming out of my breast at the incision site. I stood in the bathtub helpless for over an hour trying to get it to stop. The flow was so fast and of such a large amount. Once the flow started to slow down I packed my bra with gauze (continually changing it) and called my doctor. My doctor said that since it was pouring out on it's own, they did not want to aspirate. If they did try to drain it I would be left with very pour cosmetic results since the fluid is what was supposed to help keep me the same cup size.
Friday (2/13): I could not sleep at all last night, if I turned on my side more fluid would pour out of the incision site. I encouraged some of the fluid out by applying a small amount of pressure but I can still feel there is a ton of fluid deeper within my breast tissue. So far all seems to be completely infected (yellow/whitish cloudy fluid).

(1) Are the antibiotics going to be enough to get rid of this infection? When I look online it seems that the consensus is that it has to be cut and drained. I really do not want to have to go in and be drained, but I don't want this infection to get worse.
(2) How can I tell if the antibiotics are working? This evening will be 48 hours of antibiotics. I still have pain, there is still a lot of puss filled fluid inside my breast, but I do not have a fever.
(3) How much longer should I expect to see the puss before I should become concerned?

I am very concerned because they asked me to give an update on Monday, which means I will have to get through the weekend (they do have an emergency line I will use if necessary but I wanted to ask my questions now). I have a note out to my doctor so I am sure they will call me by the end of the day, but if you have had any experience with this, I'd greatly appreciate if you would share.

Thank you!

Kicks · February 2015

I'd be seeking a second opinion.

gemmafromlondon · February 2015

Sorry Daisey you are having this trouble. I had similar but I cannot understand why your doc opened up the wound. My axial inclusion burst nine days after surgery and gushed masses of seroma (which is what it is) I had to use sanitary towels to staunch the flow. The incision was restitched about three days later and massive amounts of antibiotics prescribed -phenoxymethylpenicillin 1000mg 4 times a day and Flucloxacillijn 1000mg 4 times a day for 14 days. It still leaked (much less) for a further three days or so. There was no question of draining as it had done it, although the area was swollen for quite a while. and the incision has been a real problem to heal.

It is important that you keep on with antibiotics until it is healed but I do think you need to get it checked out again. All the best.

Daisey4522 · February 2015

Thanks so much for sharing your experience! My did not open up the wound, it burst on it's own. I think I got the infection, not from the actual surgery, but when he scratched the glue off of the incision site, I guess so he could see how it looked (it had been a little over 2 weeks since my surgery). I just have no idea why he thought it was okay to use his nail and then did not use anything to clean up afterwards.

I was prescribed Cefadroxil 500mg twice a day for 7 days, but this was before we realized how bad the infection was.

I'm so sorry to hear what you had to go through!

Susug · February 2015

Hey Daisey,I had the same thing happen to me not nearly as bad as yours but all the same symptoms ..I felt like what I had was an infection and needed antibiotic. My bs told me it wasn't infected. .???? It. Took amounth to clear up. I peeled the glue of with the permission of my bs..BIG MISTAKE. A week later I had sentinal nodes surgery a it it did did fine.I left the

Susug · February 2015

my typing slows down the longer I type don't know what's the problem. My sentinal node did fine

Susug · February 2015

I only can type a few sentences at a time my bs told me they are not sure why some have drainage and some don't. It just takes time

ElaineTherese · February 2015

Daisey,

I'm so sorry this happened to you. I don't have any advice for you, but it's four weeks out from my lumpectomy, and there still seems to be quite a bit of fluid in the lumpectomy boob. I had never heard the "fluid is our friend" thing before; thanks for sharing. I was beginning to think there was something wrong.

Daisey4522 · February 2015

Thank you to the both of you!

(Susug you can try typing your message in Microsoft word or notepad then pasting here that may help!)

My problem is not that I have fluid, but that my fluid is super infected... It's yellow and cloudy, most likely a staph infection. I'm just wondering with out 100% drainage will I recover with antibiotics alone? I'm surprised my Dr did not give me a call back today and now it's the weekend... I guess I'll try to get through the weekend and hope for the best!

ceanna · February 2015

I found after my lymph node incision broke open from a huge seroma, that had already been drained once, and the doctor wanted to just let it drain, that using surgical wound pads from Walgreens was the best solution for the ounces of drainage per day. They are about 5x8 inches and they kept the wound clean and somewhat dry and protected my clothes. Keep on the antibiotic and it will get better with time. It's pretty shocking to see fluid drain/run from an incision!

Daisey4522 · February 2015

I think there was just so much fluid build up since such a large amount of tissue (2 large masses) were removed. It was expected that I would fill with fluid, and then the fluid became infected so it became extremely swollen, then took the path of least resistance to burst open (the incision site).

Last night I leaked the disgusting fluid all over myself again so I got up at decided to apply a slight amount of pressure to encourage the infected fluid to drain. I'm feeling extremely tired right now, but there is so much less pain in my breast and I feel so much better knowing there is not very much infected fluid left.

Thanks so much

Trvler · February 2015

I have to concur with the second opinion post. Do you have an urgent care place near you? I am kind of surprised the doctor isn't taking this more seriously.

Daisey4522 · February 2015

I do have an urgent care facility near me, but since I was able to drain most of the remaining fluid last night, I feel a lot better.

I think I'll just keep an eye on myself... I'm actually a Microbiologist by profession, so I know all these infections!

This week has been so much worse than the surgery!

cinnamonsmiles · February 2015

I would fire that doctor if that happened to me. I have fired them for less. I have never heard myself or in over 4 years on discussion boards that "fluid is our friend."

I hope things are better.

Daisey4522 · February 2015

This surgeon is actually my "second opinion surgeon" so I'm a little torn right now.. The first breast surgeon I went to see told me that since they had to remove so much mass from my breast that I would need a lot of reconstruction. They suggested implants or getting a reduction on my "good" breast. I was so upset and worried I had no idea what to do! I was told I would lose 2 cup sizes (I'm naturally a D to DD) and another surgeon said 40% of my breast.

I found this other Surgeon (my current surgeon) after reading reviews. He is actually a highly sought out top surgeon with extremely high ratings and I have to travel to another city to be seen by him. He is the director of this particular Breast center, actually, I had to make my first appointment 1.5 months in advance! My situation may be different because I am on the young side for patients that are normally seen for these conditions (I'm in my late 20's). He told me that since I'm so young that he thought he could just remove the masses and that the area would fill up with fluid and then turn into scar tissue (the fluid is typically reabsorbed by the body), and therefore my size would stay the same. I was actually shocked after the surgery. I looked great! These masses were at the surface and so easily felt and were huge! (5.6 cm and 4 cm)! I looked the same size.

The reason I am torn and feel a little upset with him, is because he used his nail to scratch off the glue covering my incision 2 weeks post surgery. I think we should have just left it on, and if he was going to remove it, then do not use your nail!! That was insane… I'm a microbiologist by profession so this is hard for me to think about! I just wish I would have thought of this the day he did it because I would have cleaned the incision site myself just to be safe.

That is when I believe I got the infection. I cannot be certain it was from him scratching the glue off, but it definitely got infected after the glue was removed. So maybe it would have happened either way.

But I will tell you, it has been pretty terrible… After I found that I was infected I was seen by a CRNP. I wish she would have given me antibiotics at that point. At least she listened to me when I insisted the following day.

Today I'm feeling so much better because the infected fluid has drained (it is my understanding that we wanted to keep this fluid in, it's just that it became infected so that is why it is now bad, otherwise the fluid would have just been reabsorbed by my body). The only thing is I feel very tired… I am guessing from my body trying to fight off the infection. It's been 2.5 days since I started the antibiotics so hopefully I am on the mend.

Thanks for all of your comments!!

Kicks · February 2015

Seek a 3rd (or 4th) opinion. Normally/Usually drains are put in after breast surgery to try to prevent seromas (fluid pockets). Seromas can cause problems, as many of us have dealt with, but do not form scar tissue to keep the breast as it was before surgery.

Often what we WANT to hear is not what is best. None of us ever wanted to hear BC and especially IBC.

gemmafromlondon · February 2015

Daisey - I know exactly how you feel. Do keep a close check on the incision and have more antibiotics if it has not healed properly; I ended up with three weeks' worth. I think it best if infected fluid gets out - the body cannot reabsorb it and it leads to further inflammation. The bursting out of fluid may have indicated an infection there already at that time. My incision has taken over two months to heal - brilliant RO said it needed fresh air but short of walking about naked I could not see how that could be managed!!

All the very best.

ElaineTherese · February 2015

Kicks -- Seromas are normally present after breast-conserving surgery, but that doesn't mean that most of those getting lumpectomies end up with drains. (I got a drain, but that was because of ALND.) Most lumpectomy seromas are just absorbed at some point. Of course, if lumpectomy seromas are deemed troublesome, they can be drained in a surgeon's office and treated with compression or an injection that helps to harden the space in the breast if necessary.

Daisey4522 · February 2015

Thank you all for your input!

I am aware of the drains that are normally put in after breast surgery, but this surgeon was insistent that I did not need them because of my age and the state of my breasts. He said he would not recommend this to someone who was older. He tapped on my skin and tested the collagen (I think). When I told him I had seen a reconstruction surgeon he said "WHY!?" shocked and insisting I most likely would not need any. This was actually not what I was wanting to hear, I was devastated because after 2 months of researching reconstruction options and reconstruction doctors and mentally torturing myself trying to make a decision I had finally made a decision of what type of surgery to go with. This was actually using a reconstruction surgeon that this breast surgeon works with (he also is highly sought out and I really got a good impression from him). This breast surgeon told me this is what he would recommend if I was his daughter… so I decided to trust him. I'm honestly not questioning his judgment in the type of surgery I got. Right after I was done with surgery I was expecting my breast to be half deflated but it looked amazing (without any reconstruction)! I thought he must have some sort of magical powers to make it look that great. The fluid did build up in my breast but I was told that would happen, I went to see him, he saw it and said it was fine. I have also done some of my own research and I have read that the fluid is reabsorbed by the body and scar tissue eventually forms.

My problem is that the incision sight seemed to become infected which caused the seroma to burst. There was still fluid left and the bacteria was allowed to grow in one of the other seroma pockets so now I have this yellowish infected fluid (instead of the clear fluid you would expect in a seroma). I encouraged some more of the infected fluid out on Saturday morning and most of it seemed to be gone. I have not leaked since then. Now the fluid seems to be building back up, I am only hoping that the antibiotics took care of the infection and the fluid is just the clear fluid that is expected.

Gemma, I'm so sorry it took so long for yours to clear up! It's really good for me to know, because maybe I will ask for more antibiotics once the 7 day supply is over. How did you know that the infection was still there? Was it because you could see at the incision site or it was leaking? It seems fluid is just building up deep within my breast but I'm not sure if it's infected still or not since it's not leaking and I'm not able to see the consistency of the fluid.

Thanks so much Elaine, that is also my understanding about the fluid after a lumpectomy. What is ALND? How long did you have your drain? I'm just curious.

Trvler · February 2015

I hope it is ok and that it is just normal fluid and the infection is gone.

Daisey4522 · February 2015

Thanks so much Trvler... I hope so too.

Maureen813 · February 2015

hi daisy

I had the same issue with a large mass removed. I wore a sanitary pad inside my bra for weeks. Seroma fluid tends to be yellowish in color and my would leak refill leak etc for weeks. Removing the steristri ps was a good move as keeping them on for too long could cause problems too. Some women need the Seroma drained is not uncommon but allowing the fluid in the pocket could result in a better outcome. Could the pain be a result from the fluid build up? That makes sense as pressure on a surgery area would cause pain with or without infection. Odor could be a cause for concern. Can you request your breast surgeon do a swab or streak to rule infection definitely and confirm your antibiotic is required and the correct one? I'd call and discuss on Monday with NP or BS. Good luck

Daisey4522 · February 2015

What a great post! Thanks so much Maureen!

I suspected the same thing as you, regarding the pain. I think the fluid build up is what causes the pain. I do not have nearly as much fluid as I did last week but it seems to be building back up and it's right under the nipple and deep within my breast under the nipple… I notice it hurts more when I feel cold, so I think the tissue is trying to retract and maybe making it even more painful as a response to the cold?

I have not leaked since Saturday morning so I'm not sure if the fluid is still infected. I suppose they would have to try to aspirate the fluid to test the resistance of the bacteria… but I am thinking that this antibiotic seems to be helping since I feel improved. I would think by now the incision site would look terrible and it looks fine. My only concern is will this 7 day supply of antibiotics be enough and how will I know without letting things get worse?

I'll give them a call tomorrow and see what they say.

Thanks for the help!

fizzdon52 · February 2015

I had the same thing a week or two after surgery, a large seroma which burst. I went on antibiotics but ended up getting Cellulitis which I was put into hospital on an IV drip for. It cleared up fine after a couple of days. If you are a Microbiologist I don't need to tell you what to look out for. Mine went rather pink and that was the first sign of Celluliltis. Good luck.

Trvler · February 2015

Keep us posted.

Daisey4522 · February 2015

Oh no! So sorry to hear about that Fizzdon! Superficially everything looks fine right now! It's just some pain (maybe from my nipple retracting due to the cold or the pressure from the new fluid build up). Regardless, I'm keeping a close eye on it. Thanks so much!!

Daisey4522 · February 2015

Thank you! I will! You all are so helpful!

I actually can't even describe how great of a support this website is from the first point of biopsy (and I did not know if it was benign or malignant), insurance questions, reconstruction questions, sugery, etc. Thank you to all of you

Maureen813 · February 2015

cellulitis is a whole different puppy! If you see hot, warm to touch with or without temp call them today. Cellulitis is nothing to mess around with.

Daisey4522 · February 2015

Maureen,

The skin was actually warm to touch on Wednesday (that's how I convinced them to prescribe me the antibiotics) but I do not think it's warm today. Yesterday I was really really tired... I think it was a big day for my body to fight off the bacteria. It's my understanding that it you typically need to be on antibiotics for 48 hours before you'll see much of a difference, so Friday night would have been 48 hours and Saturday was the day I was feeling so tired. I think I also have a couple of swollen lymph nodes... so I'm hoping the infection is on it's way out!

ElaineTherese · February 2015

Daisey, ALND stands for axillary lymph node dissection -- I had 20 lymph nodes removed during my lumpectomy. That's why I ended up with a drain. But, many lumpectomy patients never get drains; they just wait for their seromas to be absorbed. Over in the Lumpectomy Lounge, Pontiac Peggy said it took about three months for her swelling to go down and her "new old boob" to emerge. After almost 5 weeks, my lumpectomy boob still looks pretty big, but MO says that's just because of fluid. On Tuesday, I will see RO; I wonder if he'll want some of the fluid drained before he starts rads.

Daisey4522 · February 2015

Thanks Elaine. I am lucky in the two masses I had ended up being benign so I will not have to have radiation. I wish all of the best luck to you!

Post-Lumpectomy Massive Fluid Leakage and Infection!

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