persistent seroma
Comments
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Sorry, I posted this on another thread, but then realized I wanted to put it here instead. Anyway, here it is....
My history: I had a lumpy Aug 2006 almost 2 years ago. Within 6 months, a seroma appeared and got bigger. At 1 year after surgery, my surgeon said that if it didn't get absorbed on its own, he'd aspirate it. In Feb (at 18months), he stuck a needled in it and drained it.
It's now almost 2 years and yup, I have another lump under the skin. The problem is what to do about it. When it gets larger, I get occasional pain. Pressure causes major pain, so a mammogram is horrible.
Has anyone else had a persistent seroma? what did you do about it? My surgeon says that if it persists (*sigh*), what he'd recommend is to excise it. I'm NOT thrilled about surgery. I've found some options (very few) by surfing the net, but would prefer to hear what other people on this site have been told or have done.
Thanks,
Janet
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Hi Janet,
I fought seroma on my left side (the bc side) for over a year.
I had a bilateral M. two years ago last three weeks ago. (April).
I went to my surgeon several times because I just couldn't understand why I would have a hard area with fluid after having the breast removed.
He explained to me that it's not uncommon to have the fluid build up and that it accumulates in pocket like tissue so it's almost impossible to get rid of.
He told he it would soften and go down in time and it has.
He also told me to call his office with any worries which I did but I haven't seen him in a year now and even though I still have the soft tissue there I know it's fatty tissue.
I hope you don't have to have it excised.
I remember being told gentle massage will reduce the fluid.
Binney would have some excellent advise I'm sure.
Good luck Janet.
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Thanks! Yes, my surgeon also said that it would likely be reabsorbed, so we waited over a year and nothing happened except it got harder and more opaque on the mammogram film (and mammos were NOT fun on that side). So he drained it, and now a few months later it's full again.
I'm hoping that if it gets drained a few times, it'll heal without filling up again. But the massage idea is a good one. I'm going to talk to my husband about it tonight. i'm sure he'll help (*chuckle*).
Thanks. -
Janet,
I don't have a lot of time right now to respond, but I have a great deal of experience with this and will be glad to tell you more if you remind me via PM.
Bottom line is, I had a persistent seroma drained after two years. It was hard and encapsulated and was not reabsorbing, so it seemed like a no-brainer to drain it. That turned out to be a very bad decision that led to 18 months of hospitalizations for MRSA, wound care, multiple surgeries, and culminated in a mastectomy without recon.
PM me so that I don't forget to share my experience with you, because you may not be at risk as much as I now know I was.
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Janet, I will be three years out from lumpectomy in Mid august and I still have a seroma. We tried draining it twice - it immediately came back so the surgeon felt we should leave it alone. It has gone down very little but currently isn't giving me any problems and I just leave it alone. They now tell me that I may always have it.
Donna, know that you had lots of problems and that is one reason that I am content to leave it alone until it is a problem - I don't want to make it more of a problem than it is.
Janet, not sure this helps but thought I would share I've just tried to leave my alone - it also helps fill out what would otherwise be a badly shapen breast from the amount of tissue removed. Good luck
Brenda
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Thank you both. Yes, I know that draining it can lead to infection, etc. That's why I am waiting until I'm having problems. I've also read that seromas can help fill in (like a natural 'implant') (*smile*).
My only concerns are pain (and normally there's none as long as pressure isn't put on it) and the fact that it shows up as totally opaque on a mammogram (and who knows what's behind/next to it).
But I'm definitely NOT rushing in for more surgery. That's something I'll only consider if it's driving me nuts and there's nothing else to try.
Donna, I know things can turn out badly. That's why I seem to be one of the few who did NOT get my hair back after chemo (I have hair now, but I look like one of those little old men who combs hair over bare scalp), and the Herceptin left me with mild heart damage. So I KNOW that there can be bad side effects to things. I'm lucky that mine have been mild.
I'm just REALLY glad to find out that there are others who have had seromas last this long and which seem to be permanent. Thanks for sharing your experiences.
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'Morning, Janet,
One thing that can help speed the reabsorption is Manual Lymph Drainage massage practiced by a lymphedema therapist. The problem is finding one who's actually fully trained, as there are lymph massage courses out there that are really not meant to be used for medical purposes. So what you need is a therapist with at least 135 hours of specifically lymphedema training beyond his/her PT or OT certification and preferably at least a year of lymphedema experience. Call and ask before you go. I'm NOT saying this is lymphedema (in which the lymph fluid can't be aspirated because it's all over in between all the cells, not in a neat little pocket.) Just that the health professional that's trained to move fluid out of the area is a lymphedema therapist. You can use the Therapist Locator here to find one near you: www.mylymphedema.com. Click on Therapist Locator and follow all the links.
You'll need a referral from any member of your healthcare team - surgeon, onc, PCP, gyn, whoever you can convince. The therapist will teach you a simple, directed massage that will help resolve it without anything invasive.
And while you're there, ask her to do baseline arm measurements for future reference, and to fit you for a compression sleeve and glove to use prophylactically for any heavy or unusual work, exercise, and travel - helps lower your risk of ever developing lymphedema.
Win, win!
Be well,
Binney
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I wanted to bump this thread to the top because I seem to be having something similar--in my case, a chronic mini-seroma. Five years ago, I had multiple wide excisions and radiation on my right side. My breast seemed slightly swollen where all the tissue had been removed, but my surgeon wasn't concerned. Since that breast was smaller than the other as a result of the surgeries, the swelling filled it in a little. It wasn't painful, so I did nothing and after about two and a half years, one day realized that the swelling had pretty much disappeared.
Unfortunately, about six months after that, I was diagnosed with bc in the other breast and decided to have a bilateral mastectomy. After my drains were removed, I developed small seromas on both sides. The one on the left dissipated quickly and was gone after about a month. On the right, where I'd had the previous lumpectomy and radiation, it took much longer. Finally, after six months, it was mostly gone. But a tiny pocket of fluid remained and hadn't changed for over a year, until a couple of weeks ago, when I asked my physical therapist, who I still see for tightness and range of motion issues, whether anything could be done to get rid of that fluid pocket.
She has done manual lymph drainage two times over the past two weeks; I think she also worked on releasing some of the extensive scar tissue in the area. Yesterday, I noticed that there appeared to be not less, but a little more fluid. This of course alarmed me. I'm always fearing lymphedema and/or infection. I emailed my PT, who said it's possible that by releasing scar tissue, fluid that has always been there is just more obvious. I'll see her next Monday, but I wondered whether her explanation makes sense. This doesn't seem to be lymphedema--feels very jiggly like liquid, no pitting, doesn't migrate at all, no pain. This is the first time in over a year that there's been any change.
I think I probably should have left well-enough alone. Just wondering what you experts think.
Barbara
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Am no expert, but I just have apparently a permanent 'pocket' which accumulates fluid. I'll see my surgeon about it in another month. He drained it 5 months ago and it's gradually increased. It's not a lot, but it aches when pressed (or hugged). But because of scar tissue, etc, I'm leery about having more surgery to try to get rid of the pocket so it all heals together. I've never heard of scar tissue going away from massage, etc. I HAVE heard of it breaking appart a bit (which probably hurts). But no idea if that will help m.
From what I've heard, this is pretty common and doesn't cause problems for most.. And I haven't heard of any problems with LE because of this. I think you were smart to simply try to wait it out the first time (and am SO sorry to hear you had to go through all this twice).
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hi janet,
Thanks for your response. I think "releasing" scar tissue, the phrase my PT used, does mean breaking it apart, not literally getting rid of it.
Sorry that in your case the fluid came back again. I'll be interested to hear what your surgeon recommends when you see him. I have a checkup scheduled with my breast surgeon in early August. Since she doesn't believe in aspirating seromas except in rare instances, I assume she'll want to just let it be.
Barbara
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This thread apprears to be really old, but I'd be curious to find how you ladies are all doing with your seromas now. I just had a UMX on 9/1/11 and here two months later I still have fluid build up. I've had it drained once, but it came back - the surgeon PA thought I'd already had an implant. It was that big. Like you all - no pain, just squishy jiggly fluid. Do these really stick around forever?
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I found this site by searching persistent seroma. I'm new to the forum. I had a bilateral mastectomy in Feb. 2012. A seroma formed 3 wks post op. I have had it drained with a shringe every week or two for nearly 7 months. It is just under my armpit and covers the top half of my breast area. When it is full, at about 2-3 weeks, it is very painful and draining it is a relief. I am seeing a massage therapist today. She is trained in lymphadema care. I have no idea if she will be able to help me. I have had a severe infection and spent 2 months on antibiotics, so I'd sure like this to be over. Will it be over? How? Help! Has anyone had successful surgery for this after this long? 7 months? If so, what was it?
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