Surgery of any kind always involves some degree of risk, and Breast Cancer surgery is no different in that regard. The good news is that the vast majority of breast cancer surgeries across the world are completed successfully without any complications. Generally speaking, when any complications do arise, they tend to be minor and easy to deal with from a medical standpoint.
A collection of fluid, called a seroma, following breast surgery is one of the more common side effects, and the purpose of this article is to explain what causes it, what to expect, and how it is treated. Although breast surgery can be understandably daunting, fluid collection is not something that should cause any huge concerns or worries. In most cases, the problem resolves itself.
What Causes a Fluid Collection After Breast Surgery and Does It Have A Medical Name?
After surgeries where tissues have been removed, such as lumpectomies, mastectomies, or lymph node removals, fluid can sometimes try to fill newly emptied space. This fluid collection is known as a seroma.
What is seroma after surgery?
A seroma is a buildup of fluids, which accumulates and settles in an area of the body where tissue has been removed in a surgical procedure. As most breast surgeries involve the removal of tissue, seromas are a common side effect.
Once the surgery is over, fluid can start to slowly build up in the residual cavity over 7 to 10 days. Most women describe the feeling of liquid in the cavity. The fluid is one of the body’s ways of dealing with the perceived problem. Sensing that there is a problem, the brain sends liquid to that part of the body to fill the space as part of the healing process. The area can become inflamed, which is when some patients can complain of both pain and swelling. Occasionally, due to the volumes of clear liquid, a pocket of fluid can form, otherwise known as a seroma.
Sometimes a seroma will have a similar appearance to that of a cyst, and it can be tender to the touch. On rare occasions, a seroma can leave a firm lump once the remaining fluid drains away.
Where does seroma fluid come from?
If you have ever experienced a blister, then the fluid encased in a seroma is the same. Typically it is either clear or slightly yellow and is known as serous fluid. While serous fluid lumps are nothing to worry about, Dr. Gorman may decide to perform some simple tests to confirm that the lumps contain serous fluid rather than blood or pus.
Are Some Women More Susceptible To Seromas Than Others?
There is no definitive answer to this question, although there are some risk factors that can indicate an increased likelihood of a woman suffering from seromas after surgery. These include:
- Age – The older a woman is at the time of the operation the higher the risk of a seroma forming
- Breast Size – The larger the size of the breast, the more tissue may need to be removed, which seems to correspond with an increased chance of seroma.
- Previous Biopsy Surgery – The more surgical work that is undertaken in one area of the body the higher, the risk of a seroma developing.
- The use of certain medications – Certain types of medicine can increase the risk of seroma.
- A history of seromas – If a woman has previously suffered from seromas following surgery, then there is an increased likelihood that she will get them again.
Are There Any Complications To Worry About With A Seroma?
Much like a blister, a seroma can sometimes leak, any fluid that does drain should be clear, or slightly tinged with blood. However, there is a risk of infection, which could cause the seroma to develop an abscess. An abscess will not heal itself and is only likely to increase in size and become more painful. Dr. Gorman will evaluate it and determine if medication and/or a further procedure is needed.
When To Call a Doctor For Seromas
There are sure signs to keep watch for. Most are pretty standard signs of infections, but if they occur, you should contact your surgeon or another healthcare provider. These symptoms are:
- warmth in the skin around the seroma or the seroma itself
- seroma pain that gets worse
- increasing swelling and redness
- fever of 100.4°F or higher
- white, colored, or very bloody seroma fluid (reminder, the fluid should be clear, though a little blood is not unusual)
- lack of blood flow in the surgical site
- rapid heart rate
- shortness of breath
- and the wound opening again.
How Are Seromas Treated?
If you suffer from small seromas, then there is a high chance that over time they will disappear as the fluids will slowly be reabsorbed back into the body. No medication is known to be effective in reducing seromas. However, it is often beneficial to take over the counter pain medications to reduce the pain or inflammation that the seroma is causing. If a seroma becomes infected, however, antibiotics can be used to treat the infection.
How To Get Rid of a Seroma
For larger seromas, the doctor might decide that the best treatment option is to insert a needle into the seroma and then drain the excess fluid out of it. This process is known as aspiration. In some cases, this procedure may need to be repeated on more than one occasion. If the fluid continues to return even after numerous drainings, there are other options to consider.
A temporary drain can be placed to drain the fluid for several days and then removed. If other treatments do not work, surgery can be performed to remove the pocket to allow the area to heal fully.
Doctor Gorman Is Always Available
In summary, if after your surgery, a seroma does develop, make sure you contact our offices to discuss treatment options. Dr. Gorman is passionate about patient care and will want to ensure you receive the best advice and aftercare possible. Although they can be painful and irritating, seromas are hardly ever serious, so you can be confident that with a little time and patience, the body will heal itself.
Valerie Gorman, MD, FACS, is a breast cancer surgeon. She is board certified by the American Board of Surgery and serves as Chief of Surgery and Medical Director of Surgical Services at Baylor Scott & White Medical Center – Waxahachie. She is the Clinical Assistant Professor of Medical Education position at the Texas A&M University College of Medicine.
- Certificate, Physician Leadership Program, Southern Methodist University, Dallas, Texas (2010)
- M.D., University of Texas Southwestern Medical School at Dallas, Texas (June 1999)
- B.S., Biola University, LaMirada, California, (1994) Magna Cum Laude
Major: Biochemistry - Residency in General Surgery, University of Texas Southwestern Medical Center at Dallas, Texas (June 2004)