For many people living with breast cancer, completing surgery can relieve some anxiety. Unfortunately, surgery may be followed by complications — unplanned issues that may arise following a treatment — such as developing a seroma, lymphedema, or axillary web syndrome.
Seromas — collections of fluid under the skin — are the most common complication after lumpectomy (breast-conserving surgery) or mastectomy (removal of a breast). The good news is there are steps you can take to prevent or treat seromas. It’s important to know that, while some types of exercise may help prevent seromas from developing, others may trigger seroma formation and should be avoided. Read on for details.
Seromas are pockets of clear fluid in your body. They can develop in areas where you’ve had tissue surgically removed. If a seroma occurs, it’ll most likely develop within a week to a week and a half after having surgery.
A seroma can form after a lumpectomy or a mastectomy — as well as following an axillary lymph node dissection (surgery to remove the lymph nodes) 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, it’s possible for a seroma to form in your abdomen.
Members of MyBCTeam have talked about their experience with seromas. “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.
Seromas sometimes lead to additional complications, including pain, bleeding, nerve damage, or infection. They may also require removal of your breast implants if you’ve undergone breast reconstruction.
“My plastic surgeon had to drain a liter of fluid three separate times in his office,” wrote one member. “I had the implants taken out and gave up on reconstruction.”
Health experts don’t fully understand why seromas occur, but inflammation likely plays a role. Health experts have identified several risk factors for developing a seroma. These include:
In general, the more tissue that was removed, the higher the risk for developing a seroma. You have a higher risk for seromas if you had a mastectomy than a lumpectomy, and your risk also rises if you have multiple lymph nodes removed during surgery.
Your surgeon may insert drainage tubes during surgery to help extra fluid move out of the area. This may lower the risk of seromas forming. 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.”
Seromas don’t always have to be treated. 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 you can still move around normally. However, seromas may stick around for up to a year, and some require treatment.
Seromas can appear after drainage tubes have been removed. If a drainage tube is removed too soon, a seroma may form. Therefore, seromas are sometimes 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 member described.
If your seroma is not getting better, or if it’s worsening, your doctor may want to drain it. This is accomplished by inserting a thin needle into the skin and pulling out the excess liquid. Your doctor may recommend this procedure if:
If your seroma comes back after being drained, your doctor may perform sclerotherapy, in which a chemical is injected into the seroma space. The chemical irritates the surrounding vessels that are causing fluid to leak into the space and helps seal them shut, thereby preventing 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.”
After your surgery, your health care team should help you understand what type of physical activity may make a seroma worse. Following these guidelines may help you prevent seromas as well as other potential complications.
For example, many people are told to avoid lifting objects above a certain weight for a certain number of weeks after surgery.
Sitting around for long periods of time without moving can also increase your seroma risk. If, for example, you need to sit at your computer for a while, make sure to take regular breaks during which you stand up and move around.
In general, you also should avoid small, fast, repetitive movements. For example, don’t dust the living room or sweep the floor for several weeks after surgery.
For more information and specific examples of what activities are safe following surgery, talk to your doctor or physiotherapist (physical therapist). Ask whether there are certain arm or shoulder movements you should avoid during the healing process and how long you should avoid them.
It’s not entirely clear how exercise and seromas are linked.
In many cases, breast surgeons recommend performing certain arm or shoulder exercises after you undergo a surgical procedure. This can help keep these areas flexible and improve your range of motion. This type of physical activity may have other benefits. “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 dealing with a seroma.
Some older studies have found that waiting a short while to do these exercises after surgery leads to a lower risk of developing a seroma compared to beginning the exercises soon after surgery is done. However, newer studies haven’t found any difference in the rates of seroma formation based on when a person begins exercises.
In one study, participants were instructed to begin arm exercises the day after lymph node removal surgery. Those who performed their exercises twice a day were much less likely to develop a seroma compared to those who exercised once a day or not at all. Therefore, performing recommended arm exercises may help prevent this complication.
However, if you are working through exercises as part of your surgery recovery and you develop a seroma, you may have to reduce how often you perform your exercises and avoid any activities that involve lifting your arm above your head.
Ultimately, you should ask your health care team whether there are exercises that may help you after you undergo breast cancer surgery. They can help you understand your risk of seroma and determine whether certain types of exercises might be helpful or harmful based on your individual risk of complications.
On MyBCTeam — the social network for people with breast cancer and their loved ones — more than 64,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.
Have you developed a seroma after breast cancer surgery? Has your doctor recommended doing exercises or avoiding certain activities? Share your experiences in the comments below, or start a conversation by posting on your Activities page.