Post lumpectomy hematoma
I had a lumpectomy with sentinel node removal on 12/29. Clean margins and node and DNA analysis shows no need for chemo. 4 days after surgery my breast was swollen and developed a hematoma. I ham still wearing a compression bra 24/7. I have seen the surgeon 3 times for follow-up and waiting for the widespread bruising and hematoma to reabsorb. Incisions have healed but as of yesterday, 1/29 a dark spot a short distance from the end of the incision has started to bleed out dark red blood. Applied pressure has slowed it but I still keep it tightly bandaged with gauze under the compression bra as directed by the surgeon I called yesterday. Today the bleeding continues through the gauze which I change as needed. But I also feel that my already enlarged breast has swollen even more throughout the day despite the bandage and compression. I called the surgeon again who is coming in on her day off just to see me…she is an incredibly caring and wonderful doctor I am blessed to have on my care team. Is there anyone who has gone through something like this to know if there is something else that might help aside from surgery again to clean it out? I know there is a needle aspiration but the doctor says it usually does little to help due to the thicker consistency of the blood in the hematoma. Also she says the risk of infection increases with that and could make things worse. Just very discouraged after everything with the cancer itself went so well. This is my first time posting so hope I did it correctly. Thank you to any that might have ideas or encouraging ideas🥰
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Welcome, @jsohl1! We're so sorry to hear of your post-lumpectomy healing issues. While you wait for your upcoming follow-up appointment, you're following the right approach by applying pressure to try to keep the hematoma under control. Applying a cold compress / ice may help (but first confirm with your doctor that this would be ok to do in your case.) If it develops into a very large hematoma, it may require surgical drainage.
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Hi @jsohl1, I ‘m sorry you are dealing with a post surgical hematoma that won’t heal. I understand that you would prefer to do something less drastic than a re-excision but that might not be possible.
I didn’t have a problem with my lumpectomy but I dealt with a seroma after a thyroidectomy and an expanding hematoma in my hip after a fall. The seroma could be periodically aspirated since serum is thin. A surgeon tried to drain the hematoma without success. He didn’t want to attempt surgery as his last patient with a similar problem had contracted a bacterial infection that wouldn’t heal (vibrio vulnificus). He told me it might be resorbed with time. I was in a small HMO then and couldn’t afford to pay for an outside surgeon so I did nothing. I ended out with a permanent large swelling; a nurse once commented that it looked like a third butt cheek. When I finally had better insurance another surgeon told me the now very large hematoma had ossified and surgery was no longer a possibility At least it is covered by clothing most of the time
I don’t mean to scare you but it might be a good idea to go with your surgeon’s plan. She seems both competent and caring. While the cosmetic outcome might be temporarily worsened you most likely can have fat grafting or another cosmetic procedure done after your breast is healed. It’s too bad to have to deal with this when everything was going so well but sometimes the most unusual things turn up. If it is expanding, excising the hematoma and its capsule is the recommended treatment.
Good luck at your appointment and let us know how it works out. All the best.
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I met with my surgeon this morning and every visit with her deepens my appreciation for her skill and compassion. I deliberately left my overnight pressure dressing on for her to see that it does stop the bleeding, but when the dressing is removed it immediately begins leaking again. She could feel that the hematoma had grown and said that it would be best to surgically open it up and wash it out. She moved quickly and had the surgery ordered for this Monday and also the pre op appointment scheduled for as soon as I left her office. She said it’s a simple less invasive procedure so recovery will be much easier than the lumpectomy. The swelling will be down so that my radiation treatments can be scheduled. I am so very thankful and blessed to have this doctor and her skills and the support of so many as I go through this. My Gnome(?) test also came in that the odds of recurrence in 10 years is 5% So no chemo recommended! Great news! Thanks for the support offered here 🥰
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