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All TopicsForum: Surgery - Before, During, and After → Topic: Skin tissue infection after lumpectomy ? Anyone Else?

Topic: Skin tissue infection after lumpectomy ? Anyone Else?

Forum: Surgery - Before, During, and After — Surgical options and helpful tips for recovery and side effects.

Posted on: Nov 7, 2007 04:35PM, edited Nov 7, 2007 04:35PM by Chicklitzz

Chicklitzz wrote:

I'm hoping someone else has experienced what I am experiencing. I had my lumpectomy 8 weeks ago. Two weeks later had the drain taken out and everything seemed fine until another two weeks later when the skin on the other side of my breast (not the side of the surgery) started turning red and was inflamed. I was put on Cipro antibiotics and now four weeks later it is still red and inflamed, better but will not go away. I keep received reassurance that it is not IBC. But no one seems to know what's going on? Has anyone had this happen to them? I am so confused... 

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Nov 8, 2007 02:40PM Kimarene wrote:

Chicklitzz -

My situation is a little different from yours, as my problem developed in the same breast that had the tumor, but well away from the incision site.

I had my lumpectomy on 9/12 with SNB, which required radioactive isotope injections around my nipple.  Four weeks later, I developed what I thought was a bruise above my nipple.  It kept getting larger and I went to six (!) different doctors, who all said they never saw anything like it before.  Finally, a family friend who is a lactation specialist looked at it and said it looked like a staph infection.  Long story short, my surgeon put me on Keflex antibiotics for two weeks, which I just finished.  The redness definitely has diminished, but it's not totally gone.  I am supposed to begin radiation next week, and I am scared that the infection is not gone and I don't know how this will affect the effects of radiation.

Dx 8/23/2007, IDC, <1cm, Stage I, Grade 1, 0/2 nodes, ER+/PR+, HER2-
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Nov 10, 2007 08:40PM, edited Mar 19, 2008 12:00PM by TenderIsOurMight


Chicklitzz,

Tad unusual to get an infection on the other side of the lumpectomy site, but still, imo, the most likely source of persistent redness is infection (localized abscess). Having had AC and T prior to your surgery surely dropped your white count low, and then adding an incision allows a bacteria like staphylococcus (Staph) or there to creep into the breast and set up a local infection anywhere.

Perhaps a second, differing course of antibiotic, such as Keflex (also covers Staph,) or other would help out here, after insuring that your incision site is showing no signs of low grade infection itself, in which case getting a culture of the site, and cleaning of the site would be beneficial.

Simple check of your white count too may point to such, with slight elevation and more neutrophils present on it. And maybe checking your temperature should you be hot would be helpful.

Best to stay vigilant. I weight toward infection, not IBC

Kimarene,

Have to wonder if the blue dye from the SNB procedure masked the typical red color of infection, and good thing your friend was around. If redness this time deepens, then another 7 days on an antibiotic seems appropriate. I doubt that a small infection, which has lots of inflammatory cells present, will interfere with the radiation effect, but why don't you bring it to your radiation oncologist's attention ahead of time.

All the best, ladies.
Tender

It cannot be emphasized too strongly that treatment of each patient is a highly individualized matter. (FDA-approved labeling for warfarin (Coumadin) NDA 9-218/5-105)

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Nov 11, 2007 11:33AM, edited Nov 11, 2007 11:33AM by Kimarene

Tender -

Actually, my surgeon didn't use any dye in my SNB - just picked the sentinel node using a geiger counter.

I have started on my third round of antibiotics - two of Keflex and now I'm on Septra (which my doc says kills the "resistent kind" of infection).

I am going to ask the radiology oncologist about it on Wednesday (my simulation).  I spoke with the nurse about it and she seems to think it's no big deal.  Of course, it's not her breast!

Dx 8/23/2007, IDC, <1cm, Stage I, Grade 1, 0/2 nodes, ER+/PR+, HER2-
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Nov 11, 2007 09:24PM bish wrote:

Hi Kimarene,

You are wise to follow up closely. I developed an infection around the incision site (lumpectomy) about 7 days after radiation started. I started Keflex, the infection developed into a boil which had to be lanced, and then the wound packed until it healed from inside out. I had to stop radiation treatment which I then wasn't able to resume until 10 weeks later.

The doctors felt that the radiation made it difficult for my body to fight the infection and slowed the healing process. I wouldn't want to start treatment with an already established infection.

Good luck and take care.

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Nov 12, 2007 05:39AM Greenjeans wrote:

Hi Ladies,

 I developed what I thought was an infection at my incision site 6 weeks after my second lumpectomy. Turned a little red, started to open at one spot and drain.  (It was compleatly closed and looked good prior to this). Went to my gyno. that morning cultured the drainage, started antiboites. After a week the culture came back with no growth of bacteria. Dr. said it is common to have stiches start backing out???? Now I have another spot doing this. It's like where the surgeon tied knots in the stiches??? Has anyone experienced this? Everyone tells me I've been doing to much. I work in landscaping. Had my surgery on a Friday and went back to work on Monday. Didn't lift anything heavy for a week or so, and still trying to not do heavy lifting. Any thoughts?

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Nov 12, 2007 09:42AM JoelKM wrote:

My wife developed some internal bleeding due to some blood thinners she was taking shortly after surgery. She stopped the Coumadin and then reversed directions and took a vitamin K shot to shut off the bleeding. A hematoma formed and she ended up with about 3 pints of blood in her breast. That old blood creates an environment where infecton can take place. We had to have the old blood evacuated from the incision site about a month ago and she is doing much better now. Still this is goingto take 6 months to a year to completely heal. When it happened, she was in a tremendous amount of pain and hadto be hospitalized.

From the way you describe it, your situation sounds similar. I can tell you that the swelling comes and goes in the first several weeks and your breast will feel warm. It's very alarming as you are going through it. Absent a fever though, you are probably not dealing with an infection. The Cipro is probably to prevent an infection from coming on.

Spouse Dx 4/07 3.5cm IDC, Stage 2,Grade 3, ER/PR+, HER-2 neg, 3 nodes +, neoajuvent chemo DD AC-T resected 9/07

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Nov 12, 2007 09:51AM sheshe48 wrote:

Hi Clicklitzz,

This is what I experienced, A few days after my lumpectomy my incision site got infected, and it was real red on my right breast where I had my surgery. My doctor put me on Cipro and Flagel for almost 3 weeks. The Flagel took away the reddness around my breast. I hope this helps you and good luck.

The courage and strength of this challenge you face can also be met with a touch of God's grace. Rest in his arms as you lean and depend on love and support from your family and friends. If God brings you to it, he will bring you thru it.

Dx 9/4/2007, IDC, 2cm, Stage IIa, Grade 1, 0/2 nodes, ER+/PR+, HER2-Surgery 10/05/2007 Lumpectomy (Right); Lymph Node Removal (Right); Reconstruction: Tissue expander placement, Nipple reconstruction (Right)Surgery 12/05/2007 Lumpectomy (Right); Reconstruction: Tissue expander placement (Right)Chemotherapy 01/03/2008 Adriamycin, Cytoxan, TaxotereRadiation Therapy 06/01/2008 3-D conformal external beam radiation
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Jul 30, 2008 12:34PM OrliNaaman wrote:

I am so thankful to find this web site tonight!  I had a lumpectomy on 7 July.  It went well until I was waiting to leave hospital and my breast filled up with blood.  I ended up having emergency second surgery...far longer recovery and my blood is taking so long to build back up.  Still, the healing was going well until this morning when I woke with a great deal of swelling above the scar.  (I neglected to say that I also take coumadin, but was on clexane for a week prior to the surgery) I saw my doctor this afternoon and he said it was very swollen but he wasn't convinced that it was infection.  "call me and come back if it changes" (I hate hearing that).  It's now night and it is also red and hot.  Problem is that I DON'T run fevers.  At all.  I have been very ill with pneumonia and strep without fever.  I also seem to have a mouth infection and sore throat.  I feel lousy...but maybe it's stress.  Thanks so much for this chat room.  (I can't take cipro...does moxypen work??)

Dx 6/11/2008, IDC, <1cm, Stage II, Grade 2, 0/6 nodes, ER+/PR+, HER2+
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Jul 30, 2008 12:59PM ICanDoThis wrote:

I've been on clindamycin, keflex and bactrim.

Strongly recommend that you get this resolved before rads, as healing after radiation is incredibly slow and tedious.

Sue - Proud to be Krista's Mom

Dx 12/28/2007, IDC, 1cm, Stage I, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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Apr 10, 2011 06:31AM wishImay wrote:

I had a lumpectomy to remove DCIS and it was successful, "margins were widely clear," said my surgeon.  Five days later, I spiked an infection.  My breast felt like a hot ball of fire; hard and swollen.  Any touch, even the lightest, sent me off the charts.  I was hospitalized after 2 days on Cipro.  Put on IV Clindamycin and when discharged 3 days later, swelling, heat and redness significan't down, given 10 more days of Clinda.  Now one and 1/2 weeks later (3 1/2 weeks since surgery), my breast still hurts, but a lot less, is still a bit red and somewhat swollen.  It also itches, which I think is normal for surgical healing, but the rest doesn't feel normal.  I see my surgeon in two days and will hopefully find out more.  This feels awful and scary.  I hope it's a skin infection and not a wound infection, because I've heard I may need to have more surgery if that is the case.  Oh, no, no more surgery, please.  I am extremely susceptible to infection because I have a crummy immune system.  If anyone's had anything like this, please write.  

Dx 1/13/2011, DCIS, Stage 0, Grade 3
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May 15, 2011 07:27PM Leslie382 wrote:

I had a lumpectomy on March 11 and was ok, stage 2, ductal and lobular, and sentinel node removed and 37 other healthy nodes, and have been sick since. I have just about had it emotionally.

Three weeks post op I developed an inflammation in my diseased breast. No one knew what it was. They tried me on Augmentin, no help, clindomycin, no help, hospitalized me, I called in an infectious disease specialist, either mastitis or staph infection. Started me on 1500 Mg. !!!! of
Vancomycin, they call it the big heavy hitter when nothing else works. Well, I was at home with IV nurse and it is somewhat better but still hurts and the areola around the nipple turns white when I am cold and it is very painful. Got a second opinion at a major medical center. Doctor concurred with modality of treatment. I thought it was IBC but three doctors have said no.l

My internist put me on Mobic, anti inflammatory despite the fact that I am on coumadin and my cardiologist did not concur.

Bottom line, I am not doing well with the side affects of chemo. BRUTAL, and my breast still hurts and cant touch it or go to the roof . No ANSWERS! i am wondering if it is nerve damage, or just still healing from the injections given at surgery, I just dont know and I am distraught

Any ideas out there? HELP. I want my old life free of pain back.

Leslie

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May 16, 2011 08:21AM pil wrote:

Leslie, this is a terrible time you are experiencing.  I am going to arm myself with all the good things I can eat to fight infection.  I  know that sounds trivial but I have to do what I can to avoid if I can any of these painful problems.

I do hope you get to feeling better.   Thats a lot of healthy lympnodes to take out.

I wish I could help you or suggest something to help you.  March is a long time ago in terms of healing.  It could be a nerve and if it is they take a long time to heal.

So sorry.

I hope you have a better day today.

Diagnosis: Diagnosis: 5/2/2011, 1-1.9cm-Papillary Carcinoma - Grade 1 - 5/25/11 Lumpectomy, removed 6 nodes. Clear Margins 5 Years of Aromasin therapy.

Dx 5/2/2011, 1cm, Stage I, Grade 1, 0/6 nodes, ER+/PR+, HER2-
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Jun 7, 2011 02:14PM brainofkjf wrote:

I had my lumpectomy on Feb 1st, 2011, brachytherapy radiation ended in late February. Everything was healing well, though my last menstruation was during radiation. Hello menopause, finally. (I'm 52) However, since then every month just about "that time of month" the breast that had surgery became very sensitive. The lump was right behind the nipple so the docs said this is normal.  This past Saturday I woke up after a fitful night and it was REALLY sensitive. I didn't think much of it but I also felt feverish. I slept most of the day.  On Sunday I felt better.  Fever was gone but the breast was still hurting.  I went to take a shower, looked in the mirror and Whoa. One pale, lily white, Irish chick breast, and one red monster.

Yesterday I saw my radiation oncologist. It's not good when you open your gown and your very experienced RO says "WOW". The words I now despise soon followed: "Let's aspirate some fluids!" With a huge needle she pulled stuff outta me that looked like I'd had liposuction. Hurt like all heck too, worse than when they pulled out the brachytherapy catheters. Like being vacuumed from the inside. She's put me on Keflex and here it is less than 24hrs later the redness has receded significantly and I can tolerate soft clothing for short periods. Have to go back to her tomorrow for the culture results. Hoping it's not anything more than a random infection but I'm encouraged by how quickly it's responding.

Thanks to all those who have shared on this thread. It helped ease my concerns, knowing that even though this is not fun it's also not as uncommon as some websites I've browsed may indicate.

Cheers,

KJ

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Nov 1, 2013 09:06AM gilbert wrote:

I had my lumpectomy 6 weeks ago, fluid started building up and I became inflammed around the whole area. Had to go in and be drained 110cc. Left drain in for 4 days and not much drainage after that, so it was removed. The breast was almost as sore as after surgery. Now a week later fliud is building up again and stating to fell tender again. I need to go back to work but am afraid to, I drive a school bus, and it is really bumpy. Im afraid to call my boss, just don't know what to do. I'm on keflex and when they took the fluid out it did not show any infection. I was supossed to keep my arm still this whole time, it's hard to do that when you have a house to take care of.