Infected seroma 6 weeks post op

I had a lumpectomy and sentinel node biopsy 24th July. Post op I got a seroma in my armpit which was drained 3 times. Also got some cording in my arm and chest. Felt really down as I’m very sporty with running and racket sports. Things had been improving gradually and I’d been given the positive news of clear margins and no lymph node involvement. Was allowed to restart my sports which I did gradually. Then 2 days ago out of the blue my armpit suddenly got red, hot, heavy and swollen and I was feverish. This spread to breast too. I ended up at A&E and was diagnosed with an infected seroma and cellulitis. Currently in hospital on IV antibiotics. I’d not heard of this before and am shocked it can happen so late after the op. I can’t find anything online about it. So is this something that happens a lot? What have I done to create it- was it returning to sport? Am I now likely to get lymphoedema? And will this delay my radiotherapy (planning meeting 30th Sept)?

Hospital care has been appalling and I’m so glum.

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Hi, I am 7 weeks post-op. I had a single mastectomy and lymph node clearance. I have struggled with persistent seroma, it was drained once about 5 weeks ago (they drained 650 ml!) but have been reluctant to drain it since and it’s not so bad now. But my chest started to feel warm and look red and yesterday I was diagnosed with an infected seroma. I am on oral antibiotics, it’s not bad enough for hospital admission. I think it can happen at any point while you still have seroma. Shortly after it was drained I was told to cut back on the recommended exercises and not to do any other form of exercise until it had subsided so I have been just walking with very gentle arm movements and the first set of exercises we are given. I was also very active before my op so it’s been difficult, I thought I would be able to much more than I have after 7 weeks. So it seems it can happen regardless of how much you do! I hope you feel better soon

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Thank you for your reply evieb1. It helps me to know that it can happen anytime the seroma is there. Ive been worrying I caused it. None of my breast care team has really given me an answer. I’ve also been unsure how much to do with my arm so I’ll limit it for the moment too.

I hope that your oral antibiotics do the trick and wishing you all the best x

When I asked my nurse if I caused it she was very honest and said they don’t really know. She said it could happen even if all you do is sit on the sofa all day (not recommended!). In my case they think my body is a bit overenthusiastic at protecting itself. I have now cautiously restarted the recommended exercises but she said to increase very gradually so my body doesn’t overreact. Let us know how you get on x

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Thank you evieb1. I will x

Hi @poodlefluff I too had a lumpectomy and sentinel node biopsy and stayed in overnight - luckily. That night I had redness and felt unwell and had an infected haematoma and had IV antibiotics and a few days of oral antibiotics when home. Two weeks later my breast was massively swollen all the colours of the rainbow and very painful. They tried to aspirate it and took 40ml of blood basically but couldn’t drain it so I had another surgery to remove two large infected haematoma and they took 240ml in total. It gradually all settled down and I was pleased with it.

Fast forward 6 weeks and just before my first chemo was due and I had redness again around my surgical scar and it felt really lumpy. I had got an infected seroma - aspirated about half of it and then antibiotics for 14 days and chemo delayed two weeks.

Thankfully it settled and I had my first chemo two weeks ago now after review by both my surgeon and oncologist. Neither had any idea why I had such issues especially the seroma so long after my surgeries - just the luck (or not) of the draw!

It’s one of those things and won’t be anything you’ve done. I continued gently doing my exercises and don’t want to speak too soon but haven’t had any issues with my arm :crossed_fingers:t2:

I just look at it as one of those things that can happen and it’s my body’s reaction to the trauma it went through with surgery.

It’s def not something we’ve brought on ourselves!

Hope all is well very soon xx

Hello poodlefluff.

Thanks for your post. It sounds as if you are going through a difficult time after your surgery for primary breast cancer .Understandably you have been feeling down and disappointed that you now find yourself in hospital with an infected seroma and cellulitis, on intravenous antibiotics. As @evieb1 said, it can happen post-surgery and not always immediately. We look for reasons why something like this has happened, but seromas commonly develop after surgery and can get infected irrespective of what you do.

You explained you are normally fit and sporty and returning to physical exercise can help enormously mentally, coping with a diagnosis, treatment and side effects. It’s understandable that you want to get back to preoperative fitness, but your body can take time to settle down and it’s not surprising you are feeling glum. As healing takes place, these effects usually subside (get less or ease).

You mention that you have cording which can be painful and distressing. Stretching and massaging the cord can improve your symptoms and it sounds as if this is improving gradually. You may find the breast physiotherapist Jen McKenzie helpful; she has a YouTube channel where you can find videos including one on cording. Do ask your treatment team advice at this time and for clear instructions on exercise.

We also have a webinar at the end of September you may be interested in which lead by a personal trainer who was diagnosed with breast cancer, and she will be talking about exercise.

It is difficult to say whether any individual will develop lymphoedema which is swelling caused by a build-up of lymph fluid in the surface tissues of the body. This can happen as a result of damage to the lymphatic system following surgery and/or radiotherapy to the breast or armpit (axilla). Other risk factors include being overweight and infection in the arm or hand.

People who have had a sentinel lymph node biopsy, like yourself, have a reduced risk of developing lymphoedema compared to people who have had a number of lymph nodes removed.

There are ways in which to help reduce the risk of lymphoedema developing. Try to use your arm normally. Movement of your arm muscles reduces your risk of lymphoedema and encourages fluid drainage. Maintaining a healthy weight and exercising (as able) will reduce the burden on the lymphatic system.

It is best that you are fully healed and free of any infection before starting radiotherapy. Do talk to your breast care nurse or oncologist about the timing of radiotherapy as you are concerned about this, as they are best placed to advise on your individual situation.

Talking to someone who has had a similar experience can often be helpful so for example a fit sporty type of person who has had surgery and radiotherapy. Our Someone Like Me service can match you with a trained volunteer who’s had a similar experience to you. You can be in touch with your volunteer by phone or email and they can share their personal experiences to help answer your questions, offer support and listen to how you are feeling.

You can ring the Someone Like Me team on 0800 138 6551 or email them at someone.likeme@breastcancernow.org, so they can then match you to your volunteer.

If you are unhappy or have concerns about your treatment or care, the best people to speak to are the people involved. This may include your breast care nurse or hospital doctor. They are often able to help you resolve any concerns you have. If you live in England the Patient Advice and Liaison Service (PALS) can help resolve concerns related to health matters, explain, and handle complaints procedures and use feedback to help influence change. Other parts of the Uk have different organisations .

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.

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