Seroma

Hi All,
just had a seroma drained this Monday due to pain and swelling (size of a golf ball near lymph node incision). This was about 8 days after lumpectomy. I’ve never really had one before and the pain was unreal. I’m wondering if everyone still uses compression to the area after draining? I don’t have any sports bras or surgical ones that go that high on the side so I’ve been wrapping up with a wide ace bandage over sports bras. I’m fearful this will fill up again and it’s still somewhat there and slight leakage still 5 days later. Been trying a warm heating pack as well...any other tips? I’m suppose to go on vacation in 3 weeks

Hi All! I am also very frustrated with my seroma. It seems we all get conflicting advice from our doctors on how to manage them and how much time to wait or not wait in between repeated drainings. My surgeon did not want to drain it before radiation and the RO was okay with that. It went down slightly during radiation, so my mapping was re-done before my the boost, but it never got any smaller after that. When I saw my surgeon in August for my imaging, he still didn't want to drain it because he said I would probably be unhappy with the defect/dent it would leave and that the breast could still shrink from the radiation but that he would drain it if I wanted him to. I opted not to. Fast forward a few months, and in a moment of frustration I finally made an appointment and had the seroma drained. For a few blessed days, I had two breasts of the same size and could wear some of my tops I hadn't been able to wear since this whole ordeal started. My surgeon told me that if it filled up again to wait at least 4 weeks before having it drained again to reduce risk of infection and because it would be less likely to fill up again with more time in between. I have seen other postings on here where their doctors have also said to wait, and I have seen some where the doctors had the patient come in only days later for repeated drainings. I would go every day to get rid of this thing if I could!

Of course, after having my seroma drained, it filled up again, and a month later I had it drained again. The second time, I did collapse in at the lumpectomy site, but that didn't bother me as much as having this egg-sized bulge on the outside upper quadrant of my breast does.....can't wear a sweater or any form-fitting shirt or dress because it is so noticeable. I am tired of wearing loose, baggy cardigans over everything to hide it. Anyway, the surgeon said it is probably encapsulated from radiation and if so, that draining it repeatedly won't work; that it will just keep returning. He said it if it keeps returning his suggestion is that I see a plastic surgeon about having that area closed up to prevent the seroma from returning. I am about 2 1/2 weeks out from when he drained it a second time, and it is now back and at least close to its original size. I am ready to make an appointment again to see if the surgeon will at least drain it a third time to see what happens.

I feel discouraged because I have read here that many have had to have their seromas drained multiple times, but my surgeon doesn't seem to think that that will help me since mine came back so quickly and just as large as before. I can't say my seroma is huge; both times it was drained, 65 cc's of fluid came out. I know others have had much larger ones, but because of where it is, on the outer upper quadrant above my bony rib cage, coupled with the fact that I have a slight build, it appears large at least to me. It is visibly noticeable.

My questions are.....

1. Has anyone else been referred to a plastic surgeon for their seroma? Is this something that would likely be covered under a major group health insurance plan, or would it be considered cosmetic surgery and be uncovered since I had a lumpectomy and not a mastectomy? I do not have an infection, so I can't say that getting rid of the seroma is medically necessary. For me, it really is a matter of cosmetics and convenience; it bulges out right where the seam of any bra or bathing suit hits. It is tight and the pressure from it causes minor discomfort, but certainly not anything debilitating.

2. Has anyone had an encapsulated seroma that did resolve or at least get smaller with repeated draining? Or will this only work if the seroma does not become encapsulated?

3. Has anyone had a seroma that went untreated for a year that did not become encapsulated after radiation? I think my surgeon is just assuming mine is encapsulated because of radiation and for how long I have had it.

4. For those of you who had repeated drainings that worked, about how many did it take before you noticed the seroma was smaller in size when it returned?

Thank you to anyone who read all of this and has any advice!

@helenlouis, thank you. I’m watching it daily. My fear is it filling up again and I’m on my feet 8 hours a day no break. I feel like it more sore now in my breast but my tumor was pretty small so hooping so issues there. @DorothyB thank you. Surgeon sees no infection and never was on antibiotics. The swelling definitely caused pain. I took off surgical bra off after work at appt with surgeon and it was unbearable. Didn’t realize even the slight compression from bra was helping so I’ve been wrapping tight and hoping that and occasional heating helps and prevents

Thank you, Dorothy and Helenlouise!

Blackhawk, like you, I am going on vacation soon and want this seroma gone! I think what you are doing with trying to keep the area compressed and using gentle heat should help you, especially since you are still healing from your surgery. I think compression is probably the most important because you want the tissue that is healing to adhere and eliminate as much empty space as possible. I wish I had had mine drained when it first showed up after my surgery instead of waiting for my body to absorb it naturally because it never did.

I feel guilty complaining about it because to say that it pales in comparison to what I could be dealing with is quite the understatement, but it is so frustrating nonetheless. I am going to try to get in with the surgeon in the next week or two for another draining if he will do it and then ask/beg/plead with him to let me come back again right before my vacation in April to drain it one more time if necessary. Maybe I would at least get a few days of my bathing suit fitting properly lol! If that doesn't work, or if he isn't willing to drain it again, I guess I will schedule a consult with a plastic surgeon to see what my options are. I just don't want to pursue that until I know for sure that repeated aspirations won't get rid of it.

I also forgot to mention in my long post above from yesterday that when I had it drained the second time, before it filled up again I could feel some cording in that area. I can't feel it anymore now that the fluid has come back, but I wonder if one causes the other. I haven't noticed any cording down my arm, but I did have some down my rib cage last summer. At first I felt just like my ribs were very tight and couldn't understand why I couldn't get them to stretch out, and then one day, there was the long cord right down my side. I felt like I could have plucked it like a guitar string. It resolved quickly. About two months ago, I had horrific pain in my ribs under my breast that gradually did get better, but it was severe enough and lasted long enough that my MO ordered a chest and rib x-rays which came back unremarkable. I wonder now if all that pain was related to cording and that I just didn't know I had it because I couldn't feel the cord because the seroma was in the way. Just one more reason to wish this thing gone. :-)

so sorry karw41 you are having problems with seroma. I had one about a week after my lumpectomy and had to have it drained 2 or 3 times by the breast surgeon.

When I got to my radiation oncologist, she said absolutely not to have it drained any more ( it was gone by then).... reason being it was too much risk of infection.

I did use a heating pad on low for an hour , once a day. That seemed to help. Mine was under my arm in lymph node area

Fwb - It's great that you have docs who are aware of lymphadema and are pro-active. Take a look at this thread. You'll likely find some helpful information. And there are a number of LE threads on BCO.

https://www.stepup-speakout.org/

thank you for the link the articles were very helpful. Does the seroma contribute to lymphedema ? Mine both seemed to happen at the exact same time.

I appreciate the support. Having issues on top of dealing with breast cancer during pandemic is very lonely since there are no longer support groups.

jinrath, sorry you are dealing with a seroma. I had mine drained at least twice before I had radiation, and surprisingly, it got better during the rads. Mine was in the area where lymph nodes removed and not in breast, so that might have made a difference on being able to go ahead with rads. I can't help with the drain as I never had one but thought I'd bump your question to the top of the "Active Topics" page again!! All the best for quick healing.