Is a Drain for Lumpectomy + SLNB always necesary?

I had my lumpectomy (10:00, R upper outer quadrant) & SNB at a major teaching hospital with both a Breast Center of Excellence and a renowned cancer center. I did not have a drain. I did form both axillary & mammary seromas (the axillary one burst because the weight of my oversized breast was pulling it open, and it was expressed & sutured—it resorbed; the mammary one enlarged during radiation but has been slowly resorbing to smaller than it was before radiation). Whereas mastectomy and/or ALND almost always require drains, most lumpectomies with SNB don’t get them. In the latter instance, it’s probably a matter of the surgeon’s preference. Had I a drain it probably would have been in longer than usual and the seroma would have developed anyway. One of the questions my surgeon asked me at our first appointment was whether I have a tendency to develop blisters. I answered that I did—and since a seroma is basically a large internal blister, I’d likely have developed one, drain or no drain.

I had no drain for the excisional biopsy last month or my following SLNB over a week ago, HOWEVER I have already had to have my underarm drained yesterday & have to go back again tomorrow because the "goose egg" filled with fluid (seroma) is back, so I'm thinking a drain from the start might not be a bad idea! Good luck!

Back to an earlier topic, I asked my MO about the order of treatment, and from what I recall she said that there was no indication of increased benefit from doing chemo at the same time as hormone therapy, and otherwise you're having to deal with many more side effects at the same time. As for doing chemo first, she said that it's a systemic treatment to catch any lose cancer cells roaming around first. While doing radiation first only focuses on cancer cells in the breast. However, she didn't explain why hormone therapy was done after radiation for me. I guess that also doesn't explain why you wouldn't do like hormone therapy alone first for a few months and then add in chemo. But in your case, if it's looking like you won't need chemo (HER2-, of course we're waiting on SNB)), then why not start hormone therapy as soon as possible.

You are so funny - I hope your seroma continues to improve! Thanks! I keep up the rouse that I needed the seroma drained so I can start exercising. But I didn't exercise. I hope things do not change for you, and that you don't have to do chemo!