Breast Reconstruction and seroma closure

In January this year I had a right breast wide local excision and sentinel node biopsy and ICAP reconstruction - (IDC 15mm, ER/PR positive), followed by five sessions of radiotherapy in March. Generally, everything went well and I was pleased with the outcome and appearance. However, in June I developed a seroma under the right breast which was aspirated - 30mls of fluid. Throughout the summer the seroma recurred on two more occasions and was aspirated twice more. My Breast Surgeon has said that if it recurs again (and it has), I made need an operation to close the area where the fluid is forming.

I am due to see him next week and want to also ask about further reconstruction, either using my own tissue or an implant. Since having the radiotherapy, the tissues used in the original ICAP flap have gradually ‘disappeared’ and now there is no volume in that part of the breast - between my nipple and stomach. I’m 62 and previously had a 36C bust so whilst my ‘lump’ wasn’t huge, my breast has now lost at least a third of it’s volume and is very noticeable (my nipple is pointing south and is less than an inch from my stomach - well, the seroma!!). The tissue that remains is solid and painful to touch. I’ve tried various bras and padding that worked initially but I’m now requiring so much padding, it’s uncomfortable.

I know I could ask for a prosthesis but, unfortunately, feel very negative about this and would prefer a more permanent solution. My mind ‘goes to mush’ when I’m sitting in front of the doctor and thought I’d ask for your opinion first regarding the possibility of a reconstruction at the same time as having the seroma closed. Many thanks.

Hello montreal,

Thank you for posting.

It’s understandable that you have questions about the pain, volume change and the seroma that you are experiencing following your ICAP flap reconstruction. You are welcome to give us a call to talk this through.

It sounds as though this has been a difficult time for you, and it is good that you are reaching out for support.

You may find it helpful to write down the questions you want to ask your breast surgeon as many women find asking questions difficult. Sometimes it can also help to bring someone with you for support.

We cannot say whether you will be able to have another reconstruction at the same time as trying to close the seroma. This is an important question to ask your surgeon next week. They will be able to talk through your individual situation and the options that would be appropriate for you. You mention you feel very negative about using a prosthesis. We do have a Speakers Live about body image this month which you may be interested in. You can register for this session if you think it may be helpful.

We offer a range of free supportive services. They include face to face and online courses and events.

Adapting to life after treatment can be difficult and often the need for information and support continues. Coping with the shock of a diagnosis, treatment and side effects, and worries about recurrence can make it difficult to readjust to everyday life again.

You may be interested in our Moving Forward courses.

Talking to someone who has had a similar experience can often be helpful. Our Someone Like Me service can match you with a trained volunteer who’s also had issues following their reconstruction.

As already mentioned, do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to additional support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks.

The number is 0808 800 6000. If you have hearing or speech difficulties prefix our number with 18001 and the call will go through Relay UK. Our helpline has access to telephone interpreters if language translation is required.

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Best wishes

Grete

Breast Care Nurse

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