Op done but not as expected

Public Archive
1

Hi there. You may remember I posted a few weeks ago just before and after attending my local hospital for tests on a lump. At the time there was some discord between the two doctors as to the best course of action after a fine needle aspiration showed ‘atypical response’ in the cells. The grumpy consultant decided that although the lump was probably benign, he thought it best to remove it completely. His colleague was more inclined to just do a core biopsy before decided what to do next. The consultant won and I was booked in for a lump excision.

I wasn’t massively happy about this but was persuaded that it was the best thing to do - at least I would know it was all gone and couldn’t turn into anything sinister later on.

So despite the awful weather conditions etc, I attended yesterday and was operated on by a different doctor. Came round really well, no particular discomfort and feeling that I had done the right thing. The female surgeon came to talk to us briefly and said that it looked fine and we shouldn’t lose sleep over Christmas. Results due in about 3 weeks. Then the other surgeon (who had done the pre-op chat earlier in the day) came round and told us that they hadn’t removed it all! They had taken a 1cm chunk and sent that for analysis instead. I was still a little fluffy from the anaesthetic so didn’t challenge him at the time but I think he said that it appeared to be fibrous and bigger than expected and that it would have been very invasive to get it all out. If it turns out to be something nasty, they can go back in again.

By later last night it was all starting to niggle at me and by today I’m feeling very low and worried again. I consented to a lump excision on the basis that it would all be removed and all worry gone. I now have a lump of indetermined size and nature which is left in me. It may well be benign at the moment but what might it be in the future and how will I know if I get a more sinister lump later on?

Sorry to ramble but it really has rattled me. I have been feeling so utterly negative about my body (and particularly the offending article) for a while now and it’s affecting other areas of my life too. I need to find a way to get on top of this but today am feeling really let down. They may well have made the right decision but perhaps it’s more that the decision was taken out of my hands. I really don’t know.

Does anyone have any experience of this or any thoughts/comments to offer?

Phoenix

2

So sorry that the op wasnt what you expected and that you are back to waiting.
I have no advice other than to say that if they only removed a ‘sample’ and it is benign, then you will be able to preserve the shape/size of your breast… to remove the entire lump may have made a very noticable change.
I hope that your results come quickly and is good news.
Might also be useful to speak to your GP and see if they can get answers as to why the procedure wasnt as expected.
Best wishes
Marguerite

3

Further update:
Was doing really well initially. Didn’t even need any painkillers, despite being sent home with two boxes of them!

Main dressing came off on Xmas Eve as instructed, leaving steristrips to hold the wound closed. No fresh oozing or bleeding so all looking very positive.

Woke up Xmas Day with a lump. Lump has increased in size since then and is like an egg, firm to touch and visible. We were told to expect that there might be a collection of fluid to fill the hole but given that they told us the piece they removed was only 1cm square this new lump is a surprise. It is much bigger than the hole can be and also protrudes well outside the normal surface. It isn’t hot so doesn’t appear to be infection but it is tender, prickly and aches.

Probably isn’t anything to worry about in the scheme of things but as ever, it is a worry. That’s the one thing we all seem to share on here, whatever the outcome of our visits to the medics - endless anxiety! I am due to be seen some time in January for the results of the tests they’re doing on the chunk they took but am now unsure as to whether I should be contacting someone and if so, who.

Has anyone else experienced this?

4

Hi, Phoenixdragon

If your lump is not hot and red, it is probably a seroma, which is as they said a collection of fluid which is not draining away.
They are fairly common, if that’s any comfort. You can get in touch with the BCNs and ask them to drain it for you. (This is a needle through the scar, so you won’t feel much of anything.) As a temporary measure to deal with the discomfort, you can try one of those flexible freezer packs, if you have one, a packet of frozen peas or sweetcorn, or even a refrigerated wet flannel in a sandwich bag. If you use something frozen, make sure it is not in direct contact with your skin. You may find that some lying and reclining positions are more comfortable than others, and that a bit of padding helps to prevent rubbing.

My BCN recommended taking ibuprofen even if I didn’t need it for pain, though my seroma and the surrounding skin were painful for a few weeks following a 2nd op to remove all my lymph nodes.

5

…agree, sounds like Seroma, but best to let your Breast Care Nurse have a look to put your mind at ease. (you could nag her for your follow up date too…)

I have had some experience of Drs changing minds as to what is best to do first, we’re not all straightforward and sometimes it can be frustrating and upsetting, but Keep asking questions.

Ask the same questions to the different Drs - If they give different answers ask them why!

Sending gentle hugs to you. (((((()))))) P xx.

6

Ladies, thank you so much. The lump is still there but seems to changing in shape and reducing in size, which I’m taking as a good sign. Still no heat or horrible pain so I think, like you said, that seroma is the most likely explanation.

Took the steristrips off last night. Scar is inch and a half long and almost all of that is almost invisible already! (That’s my Wolverine tendencies kicking in, according to Dragon! lol) There is one end which is a little less happy and a tiny strip of broken down skin came away with the steristrip but we’ve cleaned and redressed it and there’s no new ooze so I think it will settle. Considering it’s only 8 days old it’s healing incredibly well really.

Thank you again for your support and encouragement. I hope the lump will now start to subside (even if very slowly) and we really just need those all-important results now. As we’ve all said, so so many times, it’s the waiting that’s the worst part of this and it changes how you react to even the simplest things. I’m not usually one for panicking about medical things (have had too many to mention) but this has really made me very anxious. This forum helped me very early on because I realised that anxiety is normal and acceptable.

I wish everyone on the forum the best of everything for 2011 and whatever each of us may have to face during the year, I’m sure we can get each other through it.

Phoenix
xxxx

7

A further update:

Hadn’t heard anything about my 3 week post-op appointment so thought I’d ring and check. Good job I did - appointment is tomorrow! Good news, until I realised that’s only two weeks since the op. Now I’m worried that the news isn’t great.

This worrying is becoming something of a habit I’d very much like to break!!!

Seroma lump (if that’s what it is) is reducing gradually but now have pain/ache emanating towards underarm. And last night, when I released the beastie from its containment (took my bra off!), a horrid pain shot down through the entirety of it! Most of the scar is healed but there is still one patch which is taking a little more time. Nothing wet or weeping but it has scabbed and the surrounding skin had begun to break down whereas the rest of the scar is just a thin and feint line.

Perhaps it is a good thing that I’m being seen tomorrow. Only problem is, it sounds like the original grumpy consultant is the one I’m seeing, rather than the lovely lady who did the op.

Fingers crossed and I promise to let you know the outcome.

Phoenix

8

Good luck for tomorrow keep us posted and stop panicking im sure it will be fine

9

Best of luck for tomorrow - is Dragon going with you to take notes and burn nasty consultant to ashes if he winds you up? Let us know how you get on, I’ll be thinking of you.

Sophie xx

10

lol Sophie - I wish he had!

We had to wait almost two hours and then, unfortunately, it as that same horrid consultant that called us through. He didn’t even offer a token apology for the delay and wasn’t even going to sit down!

He just said they’d looked at the sample and it was ok and at that point seemed to be trying to usher us back out of the door. Needless to say, I was determined to get something out of him so demanded to know what the diagnosis actually was. He gave an exasperated sigh (obviously we were taking up too much of his time) and then said the medical terms very quickly. I asked if I could write that down and he told me I wouldn’t be able to! He did, however, deign to do so himself, and the diagnosis is:

  1. Columar cell changes
  2. Pseudoangiomatous stromal hyperplasia

He told us it is a very rare but benign condition which was why it had been difficult to determine from the needle biopsy. He then told us that he takes the view that if you can see a lump, you should remove it. Which was exactly what was supposed to have been done in December, so I queried that with him. He sighed again and said ‘well, there’s too much of it so we’ll leave it’.

He did manage to quickly check my wound (which hadn’t quite closed at that point), prodded about which made it very uncomfortable - he was quite unconcerned about that. I queried the bigger lump which has now appeared but he says it’s not a seroma, as we all thought, but ‘probably bruising’ and his explanation for the pain under my arm is that it’s ‘probably the lymph nodes reacting’.

And with that he ushered us out of his room saying ‘if you have any problems, we could see you again’.

We should have been excited but actually just felt confused and battered by the end of it. All that build-up and then the long wait in the clinic before facing his attitude and behaviour and I could have screamed.

I’ve just posted a query on the ‘benign conditions’ forum to see if anyone has any info on this condition. There is very little ‘plain English’ stuff available on the net and I’m certainly not going to get any more info out of Mr Nasty but am left with so many questions.

Ultimately, the good news is that it is a benign condition but the way he’s handled this all along leaves me with little confidence in his management of the case. Has he done the right thing by leaving ‘it’ in situ (whatever ‘it’ is) and how will that affect me in the future?

As you can tell, head spinning still. Thank you for all your support and well wishes. Your thoughts and suggestions would be welcomed.

Phoenix
x

11

Phoenix - What a terrible time you are having. My thought was to have a word with your BCN, if you have one. She would find out the answers to your questions from him, I am certain.

Ann x

12

Phoenix, pleased it’s good news, but appalling treatment from your consultant. Is there more than one consultant on the team? If so, and you need to go back in the future, demand to see another consultant - you are perfectly within your rights.

In fact, by the way they’ve messed you about, I think I’d be looking at asking to be referred to a different hospital altogether…

Still - with any luck - you won’t need to go back at all - woo hoo!!!

Sophie xx