Seroma or truncal lymphoedema?

Hallo all - anyone out there know the difference between a seroma & truncal lymphoedema?

I thought I had a recurrence of post-surgery seroma; Fluidy-feeling swelling above mastectomy scar almost at the top of where chest joins armpit. Tickles internally like mad and feels tight/pressured in the area and uncomfy - not painful. Can’t wear bra again as it cuts in around armpit.

Phoned BCN but they don’t think it’ll be seroma at this stage (mastectomy was Sep '09) & are referring me to the Lymphoedema clinic (so much for 3 months without having to see the inside of a hospital!! Ho Hum… Arm does not look affected…

Any tips for managing the tickling in the meantime would be gratefully received - scratching THIS itch does nothing!

Hi Haxted

I don’t know the difference apart from truncal means chest area and a seroma is fluid build up.

I had a seroma on my back as I had a mastectomy with immediate dorsi flap reconstruction and all my lymph nodes removed on 17th December 2009. (I am HER2 Postive with 2 lymph nodes out of 21 affected and grade 3 tumour).

On Tuesday this week I went to see my surgeon as I had yet more fluid (haven’t seen him for a month). He drained 90ml of fluid from my back seroma. The feeling of a seroma is a soft mound of skin with fluid. It is not painful just uncomfortable to sleep with.

I also have lymphodema in my hand which is mild as it is slightly swollen. I saw a lymphodema specialist about 4 weeks ago and was told to go to the GP for lymphodema compression gloves which I did. She gave me exercises to ensure the fluid drained from my hand through the lymph channels.

The hospital I am under gives Lympodema Awareness classes. I found it really useful. You may find the same thing in your area and they are free.

I had a CT scan on Monday and they told me I also had a seroma under my arm where the lymph nodes were taken out and by my reconstruction. I have always had this lump which actually feels different to my seroma on my back and have mentioned it on numerous occasions but was told it will be sorted out after my chemo, radiotherapy and Herceptin has finished in a year’s time.

I remember I phoned my BCN to tell her I thought I had lymphodema but she said it wouldn’t happen so soon after my operation but I feel I was right.

Hi both

Lymphoedema can happen any time, unfortunately.

There also seems to a link between having a seroma and going on to develop lymphoedema…

You might be interested in this link:

ewma.org/fileadmin/user_upload/EWMA/Wound_Guidelines/Lymphoedema_Framework_Best_Practice_for_the_Management_of_Lymphoedema.pdf

(Page 3 gives list of risk factors for lymphoedema)

X to both

S

Hi, I had my mx with lymph node clearance and LD flap reconstruction on the 15th Feb. Had problems with seroma since and weekly drained with about 1 pint of fluid coming off. Have been told that there is no science to prevent it from filling up again and it will take time…
Surgeon not entirely happy with reconstruction outcome, feel that maybe I should have had my reconstruction later?
Waiting to start chemo now, but very unhappy with this slow recovery!

Hi Haxted,

We seem to be following each other. I have exactly the same symptoms (and had my mast in Sept 09). I also have pain though. I didn’t realise it could be lymphoedema as my arm isn’t affected. I’m going to hosp on Tuesday for herceptin and was planning to see my BCN anyway so I’ll ask her to have a look. The itch is maddening and I can’t find a comfortable sleeping position either. I’ve tried all sorts of bras and the swelling just keeps building up. It doesn’t help that my prosthesis is so heavy so I think it’s time to see if I can get a lighter one.

Thanks for the link Bahons2.

Jan xx

Well Jan B - Hallo again! Sorry to report that it IS lymphoedema…it wouldn’t wait till the referral for the Lymphoedema clinic! Area from armpit to base of ribs became pink & hot over the weekend & the itch was joined by an occasional internal shooting pain around the mastectomy scar so phoned BCN & they said sounds like infection in tissues & get along to GP for antibiotics. Which I did. She says def. lymphoedema in trunk and in arm also; she can feel it even though it doen’t “look” it to me. Does feel a tad tight in upper under arm though…Trouble is, since having had mx in Sept. I don’t really know what “normal” is at present! It’s never really looked smooth. Never mind - now I belong to IBC AND Lymphoedema club from whose other members I am sure I will receive more sound advice!

SO - referral to L clinic for April 6th - which I had hoped to bring forward but apparently no chance now with infection to deal with first…

I hope for your sake, that you do not also have it! Hope the return to work going okay?

Well I’m getting some good luck for once! The appointment at Lymphoedema clinic on 6th showed that it’s “mild” in my arm (@21% whatever that means) - this was revealed by the computer after I’d stuck my arm in what looked like a spin dryer and invisible (emporer’s new clothes syndrome?) lasers apparently measured the volume of my arms…Whatever - looks unlikely that I’ll need compression sleeves except for flying. Simple Lymphatic Drainage (SLD) should control it by encouraging new pathways to remaining lymph system and I’ve been taught “how”. Seems highly unlikely it’ll work - does it? Truncal lymphoedema might be sorted by this too. Sounds like a lot of “mights” to me but we’ll see in 6 weeks when I have to report back…

Spanner in works is that I can’t start that until the infection (cellulitis they’re calling it now) has cleared in chest tissues; apparently the first lot of antibiotics did not sort it & it’s still lurking there. I thought the pinkness was just marks where radiotherapy had been…What a novice…GP had prescribed 3x250mg for 5 days & protocol for this type of infection in Lymphoedema states 3x500mg for 2 weeks. So I have to start again. Oh goody - more upset tummy and thrush…(I’ve bought probiotic tablets and have a standby prescription for Canestan stuff this time!) Are infections this common in lymphoedema???