Surgery is an important part of treatment for many people with breast cancer and can bring peace of mind. Like any operation, though, it may sometimes lead to complications or problems that occur after treatment. These may include a seroma, lymphedema, or axillary web syndrome.

Seromas are collections of fluid under the skin. They are among the most common complications after lumpectomy (breast-conserving surgery) or mastectomy (removal of a breast). The good news is that there are steps you can take to prevent or treat seromas. The right kind of exercise may help lower your risk of seromas. But some moves can make them worse. Here’s what you need to know before getting started.

What Is a Seroma?

Seromas are pockets of clear fluid in your body. You can develop fluid in the breast after surgery or in an empty space where tissue has been surgically removed. If a seroma develops, it will most likely show up within a week to a week and a half after having surgery.

A seroma can form after a lumpectomy, a mastectomy, a lymph node removal, or a sentinel lymph node biopsy (a procedure to determine if cancer has spread). If you undergo breast reconstruction surgery using tissue from your abdomen, a seroma can form in your abdomen.

Members of MyBCTeam have talked about their experience with seromas after breast surgery. “It’s in my chest area where they removed the implants,” wrote one member. “There’s a huge concave area. … This is where the fluid is collecting.”

“When I press on my chest, it jiggles like Jell-O from the fluid moving under the skin,” said another.

“My plastic surgeon had to drain a liter of fluid three separate times in his office,” wrote one MyBCTeam member. “I had the implants taken out and gave up on reconstruction.”

What Causes Seromas?

Doctors don’t fully understand what causes seromas, but inflammation and the disruption of blood and lymph vessels likely play a role. Health experts have identified several risk factors for developing a seroma. These factors include:

• Moving your shoulder too much or too soon after surgery
• Having a radical mastectomy rather than a simple mastectomy
• Using vacuum drains during surgery or having drains removed too soon
• Using electrocautery (an electrically heated device to stop bleeding or remove unwanted tissue) to close wound sites
• Having increased body weight

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In general, the more tissue that’s removed, the higher the risk for developing a seroma. You have a higher risk of seromas if you had a mastectomy rather than a lumpectomy. Your risk also increases if you have multiple lymph nodes removed during surgery.

Can Seromas Be Prevented?

Your surgeon may insert drainage tubes during surgery to help extra fluid move out of the area. These tubes may lower the risk of seromas. Wearing compression garments and avoiding too many arm movements may also help minimize your risk.

One member with a history of seromas posted, “I kept myself wrapped with an Ace bandage, and that helped my body to absorb the fluid.”

Treating a Seroma

Seromas don’t always need treatment. In most cases, they disappear on their own, typically within a month. Your doctor may not recommend immediate treatment if your seroma isn’t painful and if you can still move around normally. However, seromas may stick around for up to a year, and some require treatment. Your doctor will determine how to treat a seroma depending on its size and if it doesn’t go away.

Using Tubes To Drain Seromas

Seromas can appear after drainage tubes have been removed if a drainage tube is removed too soon. Sometimes, seromas are treated by putting the tubes back in so that more fluid can drain out.

“They put a drain back in mine for my second mastectomy since the surgeon drained it twice and it built back up again,” one MyBCTeam member described.

Draining Seromas With a Needle

If your seroma doesn’t improve or continues to grow, your doctor may drain it with a procedure called aspiration. In this procedure, a thin needle is inserted through the skin, and a syringe is used to remove the extra fluid. Your doctor may recommend this procedure if:

• Your seroma is causing pain or pressure.
• The swelling is increasing.
• You can’t move the shoulder on the affected side as well as you used to.
• You experience pain, skin discoloration, or oozing.

Aspiration of a seroma with a needle is considered safe, but there is a risk of complications such as bleeding, nerve damage, damage to implants, or infection.

Sclerotherapy

If your seroma comes back after being drained, your doctor may perform sclerotherapy. In this procedure, a chemical is injected into the seroma space. The chemical irritates the tissue, which causes scarring and helps seal the space to prevent further fluid buildup. Alternatively, you may need surgery to help drain all of the extra fluid and prevent it from coming back.

One member wrote that their seroma reappeared about a day after it was drained. “I just wonder how long I’ll have this fluid,” they wrote. “It feels like a waterbed in my chest.”

Another replied, “I had mine drained three times. I still have some fluid. They told me it could take a year for it to all get absorbed back into the tissues.”

Safe Exercises After Breast Cancer Surgery

Understandably, you may be hesitant to exercise after breast cancer surgery. But it’s important to regain strength and range of motion, especially in your arm and shoulder, which are most often affected. Exercising after breast cancer surgery has many other benefits, including:

• Helping to maintain a healthy weight
• Improving mood and energy
• Reducing breast cancer treatment side effects such as nausea and fatigue
• Reducing the risk of another cancer in some cases

“They tell me I need to exercise for my osteoporosis and to help prevent cancer recurrence, so I don’t want to give up exercise,” wrote one MyBCTeam member with a seroma.

There are arm and shoulder exercises that are considered safe and beneficial after breast cancer surgery. Your doctor and oncology healthcare team can advise you on how to best perform them. It can be especially helpful to be supervised by a physical therapist (physiotherapist) to learn how to properly exercise after surgery. Your doctor can give you a referral for physical therapy (physiotherapy).

These are some exercises that can be done two or three times a day with five to 10 repetitions:

• Shoulder rolls
• Bending the elbow and then extending the arm
• Extending your arms in front of you with your fingers against a wall and walking up the wall with your fingers
• Putting your hands behind your head and gently bringing your elbows forward — either sitting in a chair or lying down on your back

The American Cancer Society recommends similar exercises after breast surgery and provides clear instructions on how to perform them. Importantly, if you’ve had a mastectomy with breast reconstruction, you should not raise your arms above your shoulders if you still have drainage tubes. You can adjust exercises based on your type of surgery to avoid raising your arms too high.

Evidence That Exercise May Help

Although you need to be careful after surgery, it’s important to gently move your arm and shoulder on the side where you’ve had breast surgery to keep the tissues flexible and regain normal shoulder movement.

With proper guidance, exercise can start as soon as one day after breast cancer surgery and has been shown to significantly improve recovery of arm and shoulder strength and range of motion, according to a recent study published in the journal JAMA Surgery. The study showed that early postoperative exercise, such as stretching and body-weight resistance training, didn’t make seromas worse.

Another research study published in the journal Acta Oncologica showed that exercise may help prevent seromas. In this study, participants were instructed to begin arm exercises for range of motion the day after lymph node removal surgery. Those who performed exercises twice a day were much less likely to develop a seroma compared to those who exercised once a day or not at all.

Some exercises, such as range-of-motion training, can help with lymphatic drainage and reduce the risk of lymphedema. Lymphedema is another type of fluid buildup that can occur after breast surgery. You should discuss gradual weight training with your doctor and wait at least a month after surgery to start using weights.

Daily Activities After Surgery

After surgery, talk to your healthcare team about physical activity that could potentially cause or worsen a seroma. Carefully following your doctor’s guidelines may help prevent seromas and other potential complications.

Many people are told to avoid lifting heavy objects for a certain number of weeks after surgery, especially if they still have drainage tubes or stitches in place. Activities such as running and jumping that can jostle the breast should also be avoided. If you’ve had lymph nodes removed, you should avoid repetitive motions, such as vacuuming or sweeping, that put strain on the side of your body where you had surgery.

Keep in Touch With Your Cancer Care Team

If you develop a seroma after breast cancer surgery, it’s important to follow up with your doctor. Your healthcare team may advise you to stop or adjust some physical activity until the seroma has healed or is no longer uncomfortable.

Your healthcare team can help you understand your risk of seroma and recommend the types of physical activity and exercise that are safest for you. Your doctor can also give you a referral for a physical therapist to help you with appropriate exercises.

Talk With Others Who Understand

On MyBCTeam, people share their experiences with breast cancer, get advice, and find support from others who understand.

Have you developed a seroma after breast cancer surgery? Has your doctor recommended doing exercises or avoiding certain activities? Share your story in the comments below.