Seroma After Mastectomy - What Is A Seroma?
Seroma after mastectomy - what is a seroma?Seroma formation is the most frequent postoperative complication after breast cancer surgery.
The suffix -oma in medicine is open to a number of translations but I suppose that the most useful is to suggest that it applies to "a gathering of" something.
So hematoma is a gathering of blood. Neuroma is a gathering of nerve endings. Lymphoma is a gathering of lymphatic cells, melanoma is a gathering of melanin (pigment) cells and hemangioma is a gathering of blood vessels.
Serous fluid is the pale yellow straw coloured fluid that is produced by lymph vessels and by the tissues that lie beneath the skin. You'll have seen serous fluid if you've ever had a blister on your hand or foot - the fluid that comes out when you puncture a blister is serous fluid.
A Seroma then is just a gathering of serous fluid.
Seroma formation is not uncommon after mastectomy surgery - particularly if the lymph glands in the armpit are removed at the same time.
Some studies suggest that between thirty and ninety percent of mastectomy patients develop a seroma. Repeated skin punctures are used to drain the seroma. These are uncomfortable and can lead to local infection. Rarely - if an infection develops - a seroma can lead to a delay in starting chemotherapy.
Normally the straw coloured serous fluid flows through the lymph vessels - tiny tubes that join up the lymph glands. If these tubes are cut or removed then the serous fluid escapes into area below the skin and gathers there - forming a soft, jelly- like swelling called a seroma.
Seroma after mastectomy is most commonly seen around the actual mastectomy wound at the front but it may develop in the armpit or even around the shoulder blade if muscle has been taken from that area to reconstruct the breast.
Seroma is thought to be caused by the fact that the mastecomy operation leaves a lot of "empty space" under the skin where the breast tissue used to be. The walls around this empty space are raw and can ooze serous fluid - causing it to gather up in the space beneath the wound. The fact that the walls of the empty space are inflamed seems to trigger the seroma fluid.
Seroma Treatment
Different surgeons and surgical units may take a different view on how best to handle a seroma after mastectomy. If the seroma becomes very large then it can be very uncomfortable and the stretching of the skin at the mastectomy site can create some pretty weird feeling sensations. In this scenario then it is an easy thing for a doctor to drain off the excess liquid with a simple needle and syringe. More than one go at this is often required.
Different procedures have been tried to avoid seroma formation.
These include immobilisation of the arm and shoulder after mastectomy, different drain regimens, closing of the dead space of the cavity, injecting different chemical substances as thrombin, tranexamacid and fibrin. None of these has been successful.
A new research project is exploring whether an injection of steroid after the surgery may help prevent seroma from forming. Early results seem promising.
If the seroma is small or is not causing any severe discomfort then your surgeon may simply opt to leave it alone. Most seromas will reabsorb themselves over a number of weeks or months.
Breaking the skin with a needle to drain a seroma leaves a slight risk of introducing infection into the area and you should bear this in mind when deciding if you need fluid drained off.
Read more about seroma after mastectomy below:
Research into seroma frequency
Sloan Kettering Article about Mastectomy and Complications
You can also read about Marjory's experience of a seroma
Check out our article resource pages for more information on seroma and on life after mastectomy
Hope this is helpful
Gordon
posted by Marjory @ 12:11 PM
Have you found this article helpful?
6 Comments:
I would like to say how useful your site is. It is so difficult to combine the personal history aspect with clear medical information about as complex a subject as breast cancer, but your site strikes what seems like pretty much the ideal balance. My partner has recently had a mastectomy and lymph node clearance and yesterday urgently felt she needed some further understanding of seroma, which she is finding extremely unpleasant to live with just when she has to visit the oncologist tomorrow to talk about chemotherapy- she had hoped to feel that the first phase (ie the surgical operation) was over with, but this puddling of fluid into the wound has prevented her feeling she has got over it. She is finding it physically repulsive on top of the post-operative scarring etc., and can't bear to have a shower at the moment. In the circumstances, she wanted to know more about seroma, whether or not to 'tough it out' for weeks or months, or have the fluid drawn off as soon as possible. Although the hospital treatment has been good and at almost all moments much better than good, there are still times when you feel you need information from other sources and in other ways - the giving of information (how rather than how much) has probably been the hospital's consistenly weakest point, despite the giving out of appropriate leaflets and a highly sympathetic nursing staff it seems that some information is left out, some only referred to in passing etc. This is understandable given the amount of information medical staff could potentially give patients, and the fact that we all vary so much, ie i guess some patients would probably prefer not to know everything. We had been looking round at websites goggling and searching with various phrases, but could only find information on post-operative lymphoedema in the arm assoicated with lymph node clearance, so it was so good to eventually find your site after an hour or so's searching, and when we had found it, read through as much of it as we could.
Thanks. I am sure Rosi will return to it again in the coming months.
i am very happy to have found this site! i had a lumpectomy a few weeks ago and now have a larger mass than what was removed. it would have been helpful to know that i should expect something like this sernoma to occur.
thank you so much for having the information we all need available!
thanks for your site. I am three weeks out from a radical mastectomy and thougt I had injured myself by doing too much too soon. knowing that the seroma is a normal by product of the surgery is very helpful. It is certainly uncomfortable but knowing that it is a common occurence makes it less scary. I am ready to get back to normal activity! Becky
I had a lumpectomy 3.5 weeks ago, with a diagnosed seroma last week, which is not enlarging, but is still extremely painful. It feels "knotty", like scar tissue perhaps? It does not need draining, however I am wondering if others out there have experienced such pain -- I mean extreme pain, just with a feather of a touch. How long does it last?
I also feel this lump and was not sure if I was doing too much with my right hand since it was the right brest removed. It just feels weird and I'm glad to have found this site to see more info on it.
I had panniculectomy and hernia repair. I would like to see more information that tells what can happen to the mesh that repaired the hernia when there is an open draining wound.Will I have to undergo more hernia surgery to help with the hernia repair? I have also had a total hip operation ( years ago) and I worry about what an infection can do to me.
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