Seroma and infection after surgery... FFS! Any advice on seroma management?

Hello everyone,

I had to have a little break for the last few weeks as feeling a bit overwhelmed with everything and also dealing with surgery and some unwanted complications… 

I had a wide local excision with round block mammoplasty on my left breast and sentinel lymph node biopsy on 11th February. About a week or so later my breast had become really swollen and tender where the tumour and margins were taken from my breast and I felt unwell with headaches, lethargy, weakness and fever so went straight to urgent care (it was early on a Saturday morning so couldn’t speak with my usual breast care team). They gave me 7 day course of oral antibiotics and I went home. I had my post-op appointment on the Monday with my surgeon and they drained 250ml of fluid off my ‘grapefruit’ boob and had samples sent off and told to continue with the antibiotics. I ended up going back into the clinic a couple of days later as boob had swollen again, was still feeling unwell and I was leaking and soaking through dressings like no tomorrow, and had another 85ml drained off. The lab results came back positive for an infection a few days after this, but I was told that the antibiotics I was on were appropriate for it.

The last couple of days I’ve been filling up again (though not as bad as before and currently not in any pain or discomfort) and have been leaking quite a bit through a teeny unclosed bit in my areola incision when I’ve been showering. I have put waterproof dressings on after showering which are much better and I don’t need to change as much now.  I finished the antibiotics course yesterday morning, but already I’m feeling a bit off again - though I’m not sure whether my anxiety about the situation is causing some psychosomatic stuff as well. Will be calling the BCNs tomorrow morning to discuss and I’m due to see surgeon again on Tuesday.

I have had some really encouraging news following the surgery (good clear margins, no cancer in any of the lymph nodes that were removed), but I’m still waiting on my oncotype dx score to come back before knowing the next steps of my treatment and meeting the oncologist.

I’m so so so effing pissed off and upset, nearly to the point of apoplexy, at developing this seroma and a bloody infection alongside it. The BCN said seromas are quite common and that usually they resolve on their own and reabsorbed back into the body over time, but they can be stubborn. Obviously with an infection on top of this I’m worried about further complications from this and I’m worried about this setback postponing the next steps in treatment, e.g radiotherapy if I don’t need chemo.

Does anyone have any tips/tricks/advice about dealing with them and helping them go away?

?Cold/heated packs:

My surgeon had mentioned icepacks for swelling, but I’ve read to the contrary on other websites saying that warm heated packs/compresses are better.

? exercises

Is it ok to still do the physiotherapy exercises for arm/shoulder, or does the exercise encourage the seroma to keep filling? The only other exercise I’m doing at the moment is a daily walk of around an hour to and hour and half and then some very gentle chair yoga. 

? Does massage help?

? Can you drain the seroma yourself at home without needing to keep going in to hospital for needle aspiration? (I don’t actually mind needles). Obviously I’m worried about further infection by doing this but there’s also risk of infection with the needles.

I will be calling my BCNs tomorrow to ask them as well but if anyone has any advice at all I’d be so grateful to hear from you. 

N xx

Hi @nicklespickles  I’m sorry to hear you are feeling overwhelmed, it sounds like you are going through a lot. I’m sure someone will be along shortly to continue the conversation and share their thoughts. 

If you have any questions for our breast care nurses, or just need a listening ear, please do not hesitate to get in touch on our freephone Helpline - 0808 800 6000. 

Best wishes, 
Shareena
Senior Digital Community Officer

Hi,

I developed a seroma under my arm about a week after surgery (lumpectomy and sentinel node biopsy).  No one had ever mentioned them.  Really painful.  Started out as a grape-sized, then walnut, and now I would say a small apricot!!

Doctor said to GENTLY massage for 2 minutes a day; use warm compresses; can use ice for pain; and constant compression of area to try to push fluid back to where it came from.  I have a ridiculous set up with gauze and ace bandages trying to push on the apricot sized lump in my underarm.  Which makes it hurt a lot.  

I recall the nurse practitioner telling me how easy the lumpectomy was and that some people found it easier than the biopsy.  Well I do not fall in that group!

I ordered little packets you warm in the microwave and a compression 1/2 shirt.  In the meanwhile I am going to do the 15 minutes of heat every few hours.

And take it easy for yet another day (very hard for me to sit still like this!).

This is my first post on this forum.  So also saying hello!