How long should I expect pain after lumpectomy?

Hi Peppermint Patti Interesting reading your post. As you have only recently had your surgery and now say you have Seroma . I wasn’t aware of seroma until a few weeks after surgery when my breast became really enlarged, inflamed, hard and sore.

I went to my GP who sent me for an ultrasound where all the fluid was seen. GP sent me to emergency and when finally seen 500 mls of fluid was drained I ended up being admitted to get antibiotics via drip for a couple of days.

A week later same thing happened I took myself to emergency it was a Sunday was admitted again another 180mls taken via ultrasound at radiation dept. and antibiotics . in all I had about 4 more drains done via planned appointments this time. No more problems since.

Be aware and ask about getting fluid drained Seroma’s don’t always go away on own.

Lymphedema of the breast is also present and exercise and physio advice helps me with this but it could always be on going.

Seroma and lymphedema a different things.

I then got an abscess at the scar site after radiation flare up another 4 weeks after, but that’s all good now!. They don’t tell you all this can happen. What a learning curve. Hope this gives a bit more information I wish I had known about this.

Keep wellxx

Thank you so much Arfie for posting.

On my post-surgery consult with the surgeon I had the Seroma &;I was on antibiotics prescribed by GP following a telephone consult in which I described a warm, red area of the breast etc.

My surgeon had asked me not to remove the pressure-type dressing but I felt I had to on that bit of breast because it felt like infection.

The surgeon did not want to send me for aspiration despite the fact that I was already on antibiotics.  I've had my pre-RT scan but am still not sure what to do about the pain.  I've switched to Paracetamol but it's not enough.

I spoke to the BCN but she didn't mention aspirating the Seroma...but did tell me that although the DCIS was 18mm, the amount removed was 62 x 54 x 31mm..so considerably more (which I'm happy about...even though clear margins declared were given simply as >2mm & >1mm at the chest wall.  It's a large amount of breast material (with areola & nipple repositioned) and so maybe it should be no surprise that I still have pain

I think the surgeon did an amazing job...great and I am grateful.

The area of skin at the Seroma resembles the description of necrosis.  I understand that RT can either shrink or increase Seroma.  The FAST-Fwd regimen may make things a bit tricky wrt Seroma (acute effects) but as I"m having Conventional RT (not Hypofrac) & Partial Breast...then I'm hoping for a better result.

I didn't know that one could get Lymphoderma in the breast itself but it makes sense.  I assumed that either my Lymphnodes were raised because they were dealing with Seroma draining  (with stinging/pain from enlarged nodes pressing on lymph drain path ...or...the Seroma impacting on nerves.  I assumed that if the lymphnodes were partially blocked then that would explain the slightly altered arm/hand sensation.....which reduces with lymphnode massage.

With RT just a week away I think that no-one will.drain the Seroma...otherwise I'd fo as you did  & ask for the Seroma etc to be examined at least via US.

Thank you again for your reply....very helpful !

Wishing you well.

PeppermintPatti.

Hi Arfir,

Is there any reason why it's not advisable to get Seroma drained before RT ? 

The only reasons that I can think of are the changes it miht make to RT plan due to movement...or a potential infection.

I've got clips in & had the planning scan but as the Seroma changes size then the clips may move & CT results altered anyway.

I was in sufgicient pain yesterday to make me cry despite full Paracetamol and Ibuprofen.  Didn't sleep much last night either (Ifind that when in pain it's better to wait til I'm exhausted).

Any reason not to have Seroma aspirated ?    RT is planned to start Wed.  Some side effects in the 1 wk were more tham a little worse than the longer schedule.  I'm not having Hypofrac either.  Of help though may be that I'm having  Partial Breast RT.

Did you have your Seroma drained before your RT  planning CT Scan ?      

Thanks,

PeppermintPatti.

Wow it took me a while to find this post not an easy site to get around.

My Seroma was long gone before my rt.  

Rt was delayed a week because of lymphoedema swelling, and concern about changes to RT  planning if swelling changes.

are you sure you have seroma (fluid in space where tissue taken in surgery) and not lymphoedema. result of lymphoedema nodes being removed in surgery.
who told you it was seroma  and not advisable to get it drained?

I would ask for an ultrasound to be sure . If it is seroma and that’s causing pain I would think it should be aspirated.That pain is the worst. However  I don’t know but I think seromas do in time go away so maybe they think yours will 

After a check with physio it was decided that the lymphoedema swelling was going to be ongoing an the rt planning went ahead I had 16 rt that was really easy. still have a lymphoedema prob but exercise and self massage help that.

I didn’t have clips don’t know about them . 

I hope you are ok seems your journey is harder than mine. Let me know how it goes ️️

Hi Again I just re red you’re previous post  can’t see then all when replying seems you have been told it’s a seroma  . I don’t know guess they think it will go away on its own . Did you ask why they didn’t think aspiration wasn’t needed, 

All the bes

Hi there Arfie,

Since posting I phoned the BCN again.  I explained that yesterday the pain was so bad I thought about going to the local hospital A &;E....or even using a syringe I have at home (I said that it was a bit extreme).  BCN spoke to Consiltant Oncoplastc surgeon inder whom my surgeon worked.  They want photo's...so I've sent 5 but it's hard to get a good selfie (lol)

My post-op Consult surgeon agrred it was a Seroma but at that point I' was nearly through a course of  antibiotics that the GP had prescribed on my description of the growing inflamed red area of skin at the Seroma site.

It's a bit too close to RT starting on Wed really to aspirate but as the Seroma changes size anyway and given the pain I had yesterday....I'm willing to risk the change wrt RT plan.

The Seroma is not big now but still is painful (yesterday was exceptionally so....I hope it's the exception).

I  should have dealt with this earlier (althougj I did show Surgeon) and did speak to BCN on Tuesday.  I  think that they should check with patients prior to RT planning CT really but........and I do try to trust their judgement and just go with their plan.

If I can control the pain then I work on the basis that either the Seroma will resolve (but prob not now) or it'll encapsulate and calcify.....and I can't do anything about that !

Let's see what the Consultant says.

Thank you for replying (& working to find the post.  I'm a Humam Factors Eng...and I have suggested that the site inttetface could do with a bit more work to improve navigation.  Even I struggled !

Thanks again,

PeppermintPatti.

Woke up this morning with pain...I think related to Seroma.  Decided to go to local A&:E.   They were fine anout me attending but it's Saturday and they didn't have the specialist Rad staff (breast) to Aspirate the Seroma.  Breast was checked.  Lymphnodes are up in armpit but no obvious infection.  Dr did mention a slight depression in skin and 'slight orange peel' effect below nippleareola in skin...so must contact BCN again first thing on Monday 4th May.

hi. I don't know how to approach this but would you mind making your own post? I posted about my breast pain and you kindly commented but our cases are very different and now I'm getting notifications about your issue not mine. I'm so sorry to ask.  I hope that's okay xx

Oops,

Sorry Arfie,

I'm.not navigating correctly / using the site correctly.

Will do.

Thanks for letting me know.

PP.

Hi how are you going I am settled and no issues decided to have the 6 month Prolia injection for bone issues after talking to others have to wait till this coronavirus allows dentist to open to get check up.Meantime doing lots of walking and trying not to focus on it all.

I am in Australia Patti seems your health system is very different from beginning  my treatment has been very coordinated and everyone has been on the same page. The Breast nurses have been the best. Do you have them to talk with about your concerns?