Is a Drain for Lumpectomy + SLNB always necesary?

Hopefully someone can tell you what a drain is like?

I had 4 after bmx. Draining them was a PITA, but not painful. Showers, I just tied them together and carried on. Sleeping wasn't a problem, the first night home in recliner then bed. 3 didn't hurt at all when they were removed, the last one did.

No big deal for me. Hope the same for you.

Hi again sportsee. When I was 16 I had a moped accident and was in the hospital for a week. I didn't realize until now, that I had a drain in my leg for the entire stay in the hospital. It didn't really matter if it was there or not because I was lying in a hospital bed that whole time. I don't know how other people healed or what their responsibilities are, but I would say after both of my surgeries, I was pretty much in bed for the first 4 days and then some, taking the percocet as prescribed, which makes you sleepy. I couldn't really do very much except give it time to heal, so if I had a drain, I don't think it would have gotten in the way of things much for the first week. Aside from getting the seroma drained by aspiration for the pain, the weather was going to be somewhat decent and I wanted to be able to walk outside, and I don't think I could do that with the friction from arm movements if the seroma was still there. I also had to sleep with my arm out to avoid putting pressure on the bump. I wonder if you just carry the drain with you or put it in your pocket?

I was given a fabric shoulder bag to carry my drains in before I left hospital. I went shopping on my way home and the drains were totally obscured. When I slept at night I opened the top drawer of my bedside table and popped them in there. There was enough tubing that I could roll over without worry of pulling them out. It wasn't until they were being removed that I realised how much tubing was inside me. They were held in place with a few stitches so very secure, and the removal process was painless.

Sportsee--I had an lx and no drain. The surgeon mentioned the possibility that I might wake up to find a drain, but his heads-up never materialized. From the variety of responses you have received, I suspect that the drain/no drain decision is based on factors like tumor size, the location of the tumor, the amount of tissue needed to be taken to ensure clean margins, and how many lymph nodes are removed, (My 1.6 cm tumor, for instance, was at 11 o'clock, 5 cm above the nipple--i.e., pretty accessible all around--and the surgeon only needed to take one node, which was clean--thus, no drain needed). You might want to ask your surgeon why s/he says you will have a drain--and if you don't like the answer, then get a second opinion.

I had lumpectomy and sentinel node biopsy.

Initially, I was told full lymph node dissection would be scheduled and that it would require drains. With the change to a simple SLNB I was told drains would not be required. I think it's MUCH more common for surgeons to do SLNB and lx w/out drains. FWIW, the tumor was also upper, outer quadrant and my sentinel nodes were scattered throughout levels I, II and III.

Drains aren't the end of the world but they are a nuisance and can be uncomfortable.

Sportsee, you are already on hormone therapy prior to surgery? And also got you entire diagnosis before surgery, too? How did that happen? They can tell all of that from the biopsy?

Hmm. I am ER+ 96%, but I won't be put on hormone therapy until after chemo and radiation - in like 6-8 months. Since I'm so strongly ER+, I am assuming 96% is high, then perhaps I should ask about doing hormone therapy earlier, too? If I am 46, doesn't estradiol start to raise really high before menopause (probably around 51)?

Anyone know what kind of thought goes into the order of chemo, radiation, and hormone therapy? I see my oncologist on Wed, so I can ask her, but your thoughts are welcome.

BTW, my phylloddes started in upper outer quadrant, but was more like from 7-12 0'clock (it was smaller at the surgery because I started my cycle - covered entire breast at the end of luteal phase). So there was a big pocket of tissue effected, but luckily the tissue came together and healed well after surgery. There seemed to be more trauma from the SNB. I also read that a drain, when placed well, can facilitate healing and help to bring the tissues together faster. But a poorly placed drain can increase infection.

Yeah, I ran into a guard rail with the moped, and cut my leg open. It ended my track career my sophomore year. My junior year I started filling out more and partying.

I had a huge incision and a large amount of tissue removed during my lumpectomy and no drain. I did have a seroma...I "sloshed" for a couple months, but the fluid reabsorbed.

I just did a quick search and just on this site it says:

The study also showed that starting hormonal therapy after chemotherapy was done was better than giving hormonal therapy and chemotherapy at the same time. Women who got tamoxifen after chemotherapy was done were 16% less likely to have a recurrence compared to women who got tamoxifen at the same time as chemotherapy. This difference also wasn't statistically significant, which means it could have been due to chance and not because of the difference in treatment.

I'm still looking for more research.

I am not sure there is no harm in waiting. I am glad to have chosen no chemo and get on AI treatment as soon as possible. Maybe in the future the technology will exist to tell if a treatment is working.

As far as chemo and hormone treatment at the same time may be working at cross purposes.

Ha! Ha! - Spookiesmom is so funny. Yes, that crossed my mind - trying to do both chemo and hormone therapy could be mighty painful.

Meow13 - What?!? There is no test to see if a treatment is working? I thought there was. Are the blood markers used for this?

Sportsee - I also read on a UK site that hormone therapy can be used (similarly like chemo is) to shrink a tumor before surgery. It will be interesting to see the size after pathology. I told my BC surgeon that my tumor was almost twice the size, covering my entire breast towards the end of my luteal phase (before period). She didn't really believe me, although they have pubmed clinical studies on it. My surgery date ended up being on the 5th day of my cycle, which I was happy about since I knew it would be smaller, Surgeon said didn't schedule around people's menstrual cycles. I think it would be worth considering when your tumor is 9cm on a small day, and twice that on a different day - it would mean way different incisions and margins.

Meow13 - Really?!?! You can go through all of the trouble to take hormone therapy and not really know if it's doing it's job? Holy cow. I had no idea.

I took a 23andme test that said I might be a CYP2D6 slow metabolizer. Something like 25% of antidepressants and some painkillers are metabolized by the CYP2D6 enzyme, and I could overdose if given them. Tamoxifen is also metabolized by that enzyme, and if you have that gene defect, the tamoxifen wouldn't work, and you'd probably be suffering with no benefit - but I guess you wouldn't know that was happening - because no one gets a gene test (that can tell you what you're allergic to before you have to have a reaction to it to find out). They're building a world class cancer center in Northern VA, and when I mentioned this to my MO, she said they have a specialist who deals with just this type of testing.