Hard Lump Under Surgical Scar After Axillary Lymph Node Surgery: Is It Normal?

There is a hard lump inside the scar from axillary lymph node surgery?

Doctor, my wife was diagnosed with stage III breast cancer five years ago, and six months ago it was discovered that the cancer had metastasized to the lymph nodes on the other side.
She underwent chemotherapy and surgery to remove 26 lymph nodes from her armpit, and the wound has been healing for six months.
Recently, we found a hard lump inside the surgical incision.
Is this normal? Thank you, doctor.

Wenz, 50~59 year old female. Ask Date: 2017/04/04

Dr. Hu Ziren reply Oncology

Hello, it is possible that there is a peripheral local recurrence after surgery.
It is recommended to discuss this in detail with your attending physician.

Reply Date: 2017/04/04

More Info

After undergoing axillary lymph node surgery, it is not uncommon for patients to notice changes in the area of the surgical scar, including the development of hard lumps. In your wife's case, having had surgery to remove 26 lymph nodes due to metastatic breast cancer, it is essential to understand the potential causes and implications of these findings.

Firstly, the presence of a hard lump under the surgical scar can be attributed to several factors. One common reason is scar tissue formation, also known as fibrosis. After surgery, the body naturally heals by forming scar tissue, which can sometimes feel firm or hard to the touch. This is a normal part of the healing process, especially in areas where significant tissue manipulation has occurred, such as during lymph node dissection.

Another possibility is the development of seromas or hematomas. A seroma is a pocket of clear fluid that can accumulate in the surgical area, while a hematoma is a collection of blood outside of blood vessels. Both can create a palpable lump and may resolve over time. If the lump is soft and fluctuates, it may indicate a seroma, while a firm, non-fluctuating lump could suggest scar tissue or a hematoma.

In some cases, the lump could also indicate an infection or other complications. Signs of infection include redness, warmth, swelling, and pain at the site of the surgery. If your wife experiences any of these symptoms, it is crucial to seek medical attention promptly.

Given your wife's medical history of breast cancer and lymph node removal, it is understandable to be concerned about any new developments in the surgical area. While the presence of a hard lump can be normal, it is always best to err on the side of caution, especially in the context of cancer treatment. I recommend that your wife schedule a follow-up appointment with her oncologist or the surgeon who performed the lymph node surgery. They can perform a physical examination and, if necessary, imaging studies to assess the lump further.

In summary, while a hard lump under the surgical scar after axillary lymph node surgery can be a normal part of the healing process, it is essential to monitor the situation closely. If there are any changes in size, shape, or associated symptoms, or if there is any concern about the nature of the lump, a medical evaluation is warranted. Regular follow-ups and open communication with healthcare providers are vital components of managing health after cancer treatment.

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