Lumpectomy Lounge....let's talk!
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Has anyone had a large hematoma after surgery? I am 1 month out from lumpectomy, IORT and oncoplastic reduction. I have some small open incisions I am dealing with on the left BC side. However, on the right, non-BC side, I have what is believed to be a large hematoma about the size of a plum. I had the PS look at it Tuesdays d he said “that’s interesting” - which is not what you want to hear. He said to massage it so it doesn’t calcify.
I am wondering if there is any other treatment? I swear it is getting larger but it just might be that I am just starting to get feeling back so maybe it is my imagination. I can’t imagine living with this large lump long term as it is on the outside, bottom portion of my breast and I am sure a regular bra will rub when I finally get to get rid of the sports bra 24/7. I am not going back to the PS until after I complete radiation so it will be about 6-8 weeks before that happens.
Would love to hear anyone’s experiences with Hematomas. Thanks, Susi
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Hi Smackan. That does sound odd. Did it just appear? Did your doctor recommend a warm compress? Once you start your radiation your breast will be checked weekly. I found I got more information from my radiation oncologist than my breast surgeon/oncologist. I didn't know it would take a year for the swelling to resolve from my sentinel node biopsy site. Good luck to you!!
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Hi Smackan,
I have a hemotoma after surgery. I also had a fall that opened up a hole around the nipple area(reduction of the breast w/o cancer) and now the hematoma seems to be draining through that hole. I am seeing a wound care Dr and every week when she pushes on the hard spot a ton of very icky stuff bubbles out. She hasn't said anything really about it other than to take a culture and to keep the wound open so it can continue to let the trapped blood escape and to heal the hole from the bottom up- it's 5cm deep right now. She did say that if the hole closed up before it healed from the bottom that either it would get infected from the trapped blood or it would harden and calcify. My PS did say that any hemotomas should be massaged daily, but I fell before that could be done. Mine was purple for a time but now is just a hard lump. It has gotten smaller with the drainage it has done. Not sure what that will mean for you but I would pursue it with as many different DR's as you can. I agree with Flashlight they will be checking you every week during radiation and I have an MO that prescribes the AI drug that also keeps tabs. Talk to them all and don't stop till you get an answer you are comfortable with and understand.
Good luck with radiation
Gail
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I have what I think is a related question. I had a lumpectomy in November of 2017 and today I have the same familiar pain that starts at the top of my hand and then into my elbow up to my arm pit. I feel it most in a stretch, slightly painful. Is this something that is normal and what I can expect every so often years after the lumpectomy? I'm just wondering if I should be worried or not?
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Sounds like cording (axillary web syndrome), which can be a harbinger of lymphedema. See an occupational therapist for massage & stretching exercises. Sometimes a cord (thought to be a clogged lymph vessel) can be visible, like a ropy vein or sinew. And often they "pop" spontaneously--a sudden sharp pain and then no more pain at all. Evidence is usually a tiny blood spot under the skin where the "pop" happened. My OT (and LE doc) managed to get my LE down to "Stage 0," or "sub-clinical." I still wear compression for long flights, however.
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I didn't have a hematoma but I did have a seroma... it formed a few weeks after surgery - it got so large that one night it burst the incision and fluid came out all over the place...dr put me on antibiotics and it leaked slowly for the next year... stopped and then started again.... finally the surgeon reopened the incision drained and cleaned out the seroma and closed the incision... the seroma never came back.
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IamNancy, stay safe. Dorian is going to be at your house tomorrow and my house on Wednesday. Pray for all of the east coast and especially the folks in the Bahamas🙏.
Bella2013
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Bella2013 -Looks like you and I are going to be fine with Dorian (hope I am not thinking this too soon) ...So sad about the people in the Bahamas - hopefully once things calm down we all can help them recover.
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Hematoma - I was back at the wound clinic today for a check on my open wounds. The one on the right is almost closed but it gets radiation starting today. The one on the left had what I suspected was a hematoma near the incision and what has now been an open wound for 4 months. I have been using collagen to heal the wound since it's over 6 cm deep and last week the Dr added silver rope to keep the hole open. All last week it was spewing all kinds of icky fluids that looked like old blood. The wound Dr today said she believes it was a hematoma because today when she pressed on the area with the knot more of the ickly fluid came out with lots of other stuff like pus and blood clots. She thinks it became infected and now is trying to disperse the old blood ect out of the open hole since it has a place to go now. So we are going to continue with current treatment and me trying to express the icky stuff when I change dressings and see if we can heal it up now. I do not want surgery again I have had enough!
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PinkArmor, so sorry to hear what you're going through--has your medical team mentioned a wound vac? Cumbersome, but it does work. I was lucky that my axillary seroma, after it exploded, was able to be "expressed" (I'll never forget that gushing spritzing sound as the surgeon worked on it) and sutured--the alternative, as the NP preferred, would have been to leave it open and pack it several times a day. Nope--I had gigs to play, a conference to attend, radiation scheduled and a cruise "at the end of the rainbow." I wasn't about to let anything stand in my way. The seroms was the size of a small orance when it burst; reduced to the size of a lemon, then a lime, then a walnut, and finally a large grape or olive before it finally disappeared almost a year out.
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ChiSandy- I'm bit nervous about the words "exploded" and "burst". 😳 I'm coming up on 4 months of my axillary seroma. It's the size of a lemon now. What caused yours to "explode"
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According to my surgeon's partner (who did the repair), it was the weight of my very large breast (a 38 "I" cup before lumpectomy, now down to a 40F or at most 38G) that pulled the seroma incision open. That incision was closed with surgical glue and Steri-Strips, which were no match for Super-Boob. (The intact L one is even bigger). Mine burst at 3-1/2 weeks. (Thankful it wasn't earlier--a week before, I had to drive 90 mi. to Rockford to play a gig, and I don't know what I'd have done had it burst onstage or in transit). It was re-closed, this time with sutures. Removed 2 wks after that (just in time to drive to IA for a conference), and it held. Took a year to fully resorb. Only "souvenir" of that is a bit of residual numbness--for awhile, my pit was hairless, but now I have to carefully shave it again should I want to wear a swimsuit or tank top.
Rest assured that most seromas behave themselves and eventually shrink on their own. MIne was an outlier--but then again, so are Thelma & Louise (my "girls").
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Not sure if this is ok to post in this thread because I haven’t been diagnosed with anything so far. But a couple weeks ago when I was googling discordant needle biopsy results because I didn’t understand why surgery was being recommended, I found a bunch of information in here that explained it so here it goes.zxxz
Weird question. Is it normal to feel completely great after having an excisional biopsy? Is this the calm before the storm? I had one done yesterday morning after having a core needle biopsy done last month. The needle biopsy results were "discordant" with the pathology report so they recommended surgery. The pathology report showed normal breast tissue but that isn't what they were expecting based on the mammogram/ultrasound. I felt fine after the needle biopsy too. And didn't feel anything when they inserted a radioactive seed last week. I typically have a pretty high tolerance for pain but figured surgery would be different.
I have had no pain at all at the incision site....yet. And wasn't tired or groggy at all when I got home even though they had to change plans during the procedure and intubate because I started getting a cold last Thursday, a few hours after they inserted the seed. I guess they had to suction a bunch of mucus from my lungs. I figured I would have at least had a sore throat but that feels fine too. I'm wondering if they used some sort of long acting local anesthetic that is going to wear off tomorrow and I'm going to be miserable. My breast doesn't feel numb at all though so I'm thinking that isn't the case. The surgeon did say that whatever they removed was definitely abnormal but because fibrocystic tissue and malignant tissue look similar, he can't tell with out the pathology report.
The only weird symptom I have is that the back of both calves are really sore. Feels like I walked 5 miles yesterday. No signs of swelling or bruising and they aren't hot to the touch so I don't think it's anything to worry about. Just odd.
When I was 18, I had a lumpectomy (or at least that’s what they called it) to remove a palpable lump in my right breast. It was benign and I was told I had fibrocystic breasts and was basically told self breast exams were kind of a waste of time. All I remember about the surgery is being put under anesthesia for the first time. I don't even think they did any diagnostic testing prior to the surgery. Things were a lot different 28 years ago. Lol
I was supposed to start getting mammograms when I turned 40 in 2013 but was always so busy at work that I never got around to it. I finally started having mammograms in 2018 when I turned 45. There was an area in my left breast that they had me doing 6 month mammo's on but at my yearly one in March 2019, they said that was stable but they saw suspicious area in my right breast and recommended a needle biopsy. But I didn't have any flex spending left to pay for my deductible so I put it off until August because they said the risk level was really low that it actually was anything. I should have the pathology report Wednesday or Thursday.
I have no regrets on waiting. I strongly believe that everything happens exactly when it is supposed to and trust in God's plan for my life. If that includes cancer, then so be it. I'm sure I will deal with it if it happens. Worrying won't help anything. I'm just naturally curious and feel better when I know other people's experiences. Knowledge is power!
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If you had a general (and it sounds like you did because you said you "guess" they had to suction your lungs but presumably don't recall them doing it), right after you "go under" but before the first incision you're given (in your I.V.) a strong muscle relaxant called succinylcholine (on TV medical dramas, that's what they mean when in the ER they yell "sux!"Not a value judgment). It is given to make sure you lie perfectly still on the table so they can intubate you with no flinching, precisely locate the tumor/lump and take no more tissue than they need. But before it relaxes your muscles, it first powerfully contracts them for an instant. Those contractions are the equivalent of going into the gym never having done strength training but doing the machines on max. weight. It can take 2-3 days to kick in, but you will have muscle stiffness & soreness (especially upper body) like the day after your first Nautilus session at max! By the time you read this, you'll probably be feeling it from your abs up to your collarbone, but it sounds like your gastrocs (calf muscles) contracted too. The phenomenon is called "scoline syndrome" ("scoline" being slang for succinylcholine) and it lasts anywhere from 2-4 days post-op before it begins to ease. You might also have been "under" longer than you thought, because of the suctioning, and lying supine like that on a hard operating table may have caused some bruising in your gastrocs when the contracted against the hard surface.
As for little-to-no breast pain, that's par for the course. I didn't believe it when my surgeon's NP wouldn't write me a script for Norco to fill in advance, but after that one I.V. push of Fentanyl in the recovery room, they gave me 2 regular (325, not 500mg) Tylenol, a mini-bagel & schmear, OJ & coffee and discharged me. I needed no more than Tylenol & ice the first couple of days and then occasional ice after that.
An excisional biopsy is and isn't a "lumpectomy." Normally, a lumpectomy is done after core needle or incisional (for close-to-the-surface lesions) biopsy returns a diagnosis of breast cancer or atypical hyperplasia. An excisional biopsy is a lumpectomy done not to remove a malignancy but to remove a suspicious area that may or may not be malignant, but core-needle or incisional biopsy results are either discordant with each other or with what imaging suggests, or inconclusive. A true lumpectomy's margins (the area of surrounding normal tissue removed) are larger--because it's been established there's a malignancy and it's necessary to take enough surrounding tissue to avoid leaving cancer cells behind. An excisional biopsy's margins are just wide enough to make sure they got the whole thing to test various portions of it, but leave enough surrounding tissue intact in case the results are benign. A lumpectomy is also done in conjunction with a sentinel-node biopsy (SNB) to determine if the cancer has spread to the lymph nodes; an SNB isn't done with an excisional biopsy because if the excised tumor is benign, there's no need to assess the lymph nodes.
It also isn't unusual to feel as calm as you do. The knowledge that you have taken charge of your health, rather than endlessly mulling the uncertainties & worst-case scenarios can be a huge relief. I know I felt calmer (after the initial shock wave) after my core needle biopsy results than I did in the days between it and the abnormal imaging that indicated the need for it--the unknown is always scarier. And I felt better still after my surgeon & onc. appts., and even more relieved after the lumpectomy & SNB, knowing we were moving ahead with getting me well again. So you don't have to worry that you have a "blunted affect" or that there will be a delayed emotional reaction to hit you like a ton of bricks. You are calm because you are empowered.
And whatever the results may be, you can handle them, armed with the knowledge, advice & support you'll find here, We have an expression "in your pocket for..." to express that whatever tests, procedures or treatments come next, we'll be figuratively right there with you (but invisible of course).
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ChiSandy....Thank you for all of that information!!!! I had read an earlier post about the scolding syndrome but it had said about it being the upper body and not kicking in right away so I wasn’t sure if that might be the cause. Today, my back is kind of sore but that could just be because I slept on my couch. I took one Norco last night around midnight just in case I did have a long acting local because I had a twinge and didn’t want to wake up in pain and I figured it would help me sleep. I felt no different after taking that pill, not loopy or anything. And I swear it counteracted my sleep meds because I didn’t feel tired enough to fall asleep until 4:30am. I won’t make that mistake again!
All of the people at the Breast Imaging Center, the surgeon’s office, and the hospital yesterday are super nice but they all seem to look at me like I’m crazy because I’m calm. Like I’m under-reacting. Or they know something I don’t. Before the surgery yesterday, the surgeon said he thought there was a less than 5% chance it’s cancer but based on what he told my husband, it sounded like the percentage may have gone up
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Hi, Finally got my IORT surgery schedule: Seed Placement 9/30, IORT (lumpectomy with intraoperative radiation) 10/2. Originally I was scheduled for 8/28 surgery. Thank you for prayers, positive thoughts, and all the support you've given thus far! Hugs to all.
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Back atcha, CherokeeLady!
saintgeorge, not everyone gets a sedating effect from opioids--some people have "paradoxical" (the opposite of the usual) reactions to some meds. If you are already on prescription sleep meds it's not a good idea to combine them with opioids. Usually, it's a dangerous combination because it can depress respirations, but again, depending on what that sleep med is, you might have a paradoxical reaction of the two drugs' beneficial effects canceling each other out--but still putting a load on the liver. All of the risk and none of the benefit.
You can get CBD now in all 50 states, and many people take it to bring on natural sleep. If you live in a recreational marijuana state, I'd suggest seeing if the dispensaries sell CBN capsules or patches for sleep. (My state has medical marijuana, and I got my card last Nov.; the medical dispensary where I had to register carries CBN capsules). CBN is a cannabinoid that is particularly good for both pain control and sleep--it's much more sedating than CBD and has none of the "high" of marijuana.
If you don't have recreational or medical dispensaries, or don't have a medical marijuana ID card (you probably haven't been diagnosed with a "qualifying condition," and won't if your biopsy comes back benign), but do have access to a CBD boutique (not one of those tacky degenerate "Vape-Kratom-CBD" smoke shops), they may have a night-formula CBD tincture with CBN in it. (I like Denver's "Night Serum;" pricy but neutral taste and it works. The boutique where I got it now carries a different brand, HempPanna, with a bit more CBN, but I'm not nuts about the taste). You can buy CBD/CBN tinctures online, but for some reason pure CBN is available only at dispensaries (perhaps because THC eventually degrades into CBN). The legal combo versions are available because industrial hemp contains 0.3% THC, so when CBD is extracted by distillation, the mfr. separatea out the THC--the THC-free versions of CBD are in demand these days because they won't cause one to flunk a drug test. When they get enough THC, they convert it by heating into CBN to mix with CBD for a "sleep" tincture. The amount of hemp it takes to get enough THC to convert to CBN explains the high price. At the dispensaries, the pure CBN sold is distilled from marijuana that's gone stale (or is not a good crop to meet consumer demand for specific strains.
Since I discovered CBD, I haven't taken an opioid--been more than a year now, after orthopedic surgery I had.
Oh, and the reason you don't have a sore throat is probably because they used a small, even a pediatric, airway to intubate you. As a singer, I always request a pediatric airway to keep from irritating my vocal folds.
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ChiSandy....I’ve seen conflicting things on whether it is better to ice or heat in the days after surgery. It seems like I’ve would be good for swelling/bruising but I’ve also seen where heat is good to help prevent a hematoma. Both feel good. The discharge paperwork said nothing about ice after surgery but they told me I was supposed to use it after my core needle biopsy. I’m so confused.
On a positive note, I’m less sore today. My calves are completely back to normal and my shoulders are way better. It’s just my obliques that hurt when I cough/sneeze/laugh now.
No pathology report yet....maybe tomorrow. :
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Ice is usually for the immediate (or at most short-term) aftermath of an injury, to reduce swelling and numb pain; heat is good afterward for relaxing muscles & combating stiffness not due to swelling. I was not told to use heat after my lumpectomy, and I didn't get a hematoma. (If there's any possibility of infection, heat should be avoided as it tends to help pathogens grow). The muscle pain should be gone by Friday,
Fingers crossed for benign results; but if malignant, the least aggressive form of early stage breast cancer.
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Dear Dr. ChiSandy,
Should I worry about this: I had a good size lumpectomy in February followed by 33 radiation treatments. If anyone wanted a 70 year old swim suit model it could be me. I am totally symmetrical, not even a visible scar. I worry because I think it should be much smaller. It feels tight when I stretch my arm but not at all debilitating. I guess I’m finished, I had a clean mammogram last week. You always have good information. Thanks
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Hi Benji69, I'm not ChiSandy, but I'm 68 and finished radiation last March. My lumpectomy scar is hardly visible, but where my Sentinel node was removed remains swollen. The RO said it would take a good year to resolve. I was very tight in June, July , and started to loosen up mid August. My breast is the same size as always so far. Good news about your mammogram! Mine was also clear. I was happy they lined the plexiglass with a pink cushion! I start the Livestrong program next week and hope to get some of strength back. Good luck to you.
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Benji69, do keep stretching that arm. Those underarm nodes removal sites are a pain. Even after 5 years, I still need to remember to stretch several times a week. You'd think that after so long it wouldn't be necessary. Just a fact of life. Congrats on the good mammogram!!
HUGS!
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Thanks Peggy
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And flashlight
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I am nearly 6 months since lumpectomy, 3 months since end of rads. Scars barely visible. . .and I can still feel both scars on occasion. One B cup, one C cup now but pretty symmetrical. My nipple still scales a bit and breast and chest is slightly darker and more leathery. Tired still (the Arimidex is my guess). And again, the Arimidex (two months now) has given me 10-12 dizzy/soaking sweats day and night. Hoping they abate soon. When people ask, I say I am about 80%.
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Tightness - surgery was almost 2 years ago. Small breasted, BS went down to my pectoral muscle during reexcision. I still have tightness in that pec. I work out 4-5x a week, stretch daily, it is what it is. At this point I doubt it will ever get back to what it was prior to surgery. But I'm ok with that, it doesn't impead my workouts (I just know its limited), and has no bearing on my daily life.
Stretch as needed, but don't be disappointed if it doesn't go back to the way it was "before BC."
Best wishes to all!
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Benji I had tightness after rad and was referred to a physical therapist that specializes working with BC patients and working with her was great. I could tell my range of motion was off and she got me almost back to normal.
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I had cording after rads--first one "popped" right after I made my first LE doc appt. (go figure!) and second one happened after I experienced mild finger swelling on a return transatlantic flight, compression sleeve & gauntlet notwithstanding. (LE doc prescribed a glove, which was horribly uncomfortable). OT was great at breaking up that cord, and manual lymph drainage self-massage helped immensely. I still get little divots from Pandora charms (which I incorporated into the medical-alert bracelet I wear: warning about LE, abx allergies, HBP & and asthma), but the ring I wear as a "barometer" on one of my R hand fingers is almost always loose (except when a storm is coming on or I'm riding on a super-fast skyscraper elevator to the top).
I ignored my NP's admonition not to do any stretching after surgery---I did "wall-walking" with my fingers, which was what my MIL did after her UMX when she was my age. (Think the "Itsy-Bitsy Spider" gestures when you sang it to your kids). I'm convinced that despite that cord, it was what let me keep a normal range of motion. I still do, because that's what my personal trainer had me do in 2016-17 as part of my post-workout stretches. (Gotta get that stupid toe of mine healed or at least well-padded so I can resume training, per my orthopod's advice a year after my ulnar surgery).
I had a little redness (not itchy or painful) in the "target" area, which turned to a slight tan; that nipple & areola are darker & harder than on my "normal" L breast. But ironically, the R breast is rounder and "perkier" (well, as "perky" as an oversized natural breast can be).
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I have been experiencing breast pain on my "good" side for three days. This pain is very unusual. I have experienced sore boobs in general and sharp stabbing pains throughout my life but this pain is very localized to one spot. The pain feels like a pinching sensation. It feels very odd. Maybe a prickly feeling. Has anexperienced this type of pain?
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Shockedat48-
If I were you I'd give you Dr a call, can't hurt having it checked out. Our minds go directly to BC, when hopefully it's nothing of the sort.
I had my yearly mammo and ultrasound today, 2nd one since my LX. It was not as painful as the first one last year, which is a blessing. And they let me know it all looked clear. My BS will get a copy of the report, and I see her for 6 month check at the end of the month. I mentioned in another post, I was sweating - trying to be calm but arm pits gave me away.
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