Post-Surgery Axillary Pain and Fluid Accumulation in Ductal Carcinoma

Postoperative axillary swelling and pain after ductal carcinoma in situ (DCIS) surgery?

Hello Doctor, I would like to ask about ductal carcinoma in situ.
I have undergone a partial mastectomy, during which two sentinel lymph nodes were removed, and they showed no cancer cell metastasis.
Post-surgery, there is no swelling in my arm, but I have lymphatic fluid accumulation and pain in my axilla, approximately the size of an apple.
I have had the fluid drained from my axilla several times, but it continues to accumulate.
I would like to ask the following questions: 1.
What is the cause of the fluid accumulation and pain in my axilla? 2.
How long does axillary fluid accumulation typically last? Will it persist indefinitely? 3.
Given the partial mastectomy and sentinel lymph node removal, what precautions should I take in my daily life to prevent future axillary fluid accumulation and pain? Thank you, Doctor!

Wei, 50~59 year old female. Ask Date: 2022/08/31

Dr. Li Zhonghuai reply Surgery

Hello! Fluid accumulation in the axilla is produced by lymphatic vessels.
Generally, lymphatic vessels will repair themselves after surgery, and the fluid will gradually be absorbed.
You can use a compression garment to apply slight pressure, but some patients may require multiple aspirations for resolution, especially those who are overweight.
There’s not much to worry about; just maintain a balanced diet and avoid barbecued, fried, and sugary refined foods.
If the fluid does not resolve, some physicians may administer antibiotics.
Take care! Changhua Hospital is concerned about you!

Reply Date: 2022/08/31

More Info

Post-surgery axillary pain and fluid accumulation following a partial mastectomy for ductal carcinoma in situ (DCIS) can be concerning for patients. Here’s a detailed response to your questions based on medical knowledge and practices.

1. Causes of Axillary Fluid Accumulation and Pain: The accumulation of fluid in the axillary region, often referred to as seroma, can occur after surgery due to several factors. When lymph nodes are removed, as in your case with the excision of two sentinel lymph nodes, the normal flow of lymphatic fluid can be disrupted. This disruption can lead to fluid pooling in the area, resulting in swelling and discomfort. Additionally, surgical trauma to the tissues can cause inflammation, which may also contribute to fluid accumulation. Other potential causes include infection or hematoma (a collection of blood outside of blood vessels), although these are less common if there are no signs of infection or significant bruising.

2. Duration of Axillary Fluid Accumulation: The duration of seroma can vary significantly from patient to patient. In many cases, seromas can resolve on their own within a few weeks to a couple of months. However, some patients may experience persistent seromas that require repeated drainage. If the seroma continues to recur after drainage, it may be necessary to consider further interventions, such as compression garments or, in rare cases, surgical revision to address the underlying issue.

3. Daily Life Considerations Post-Surgery: After surgery for breast cancer, especially with lymph node removal, it is crucial to take certain precautions to minimize the risk of complications such as lymphedema (swelling due to lymph fluid). Here are some recommendations:
- Avoid Heavy Lifting: Refrain from lifting heavy objects with the affected arm for several weeks post-surgery to reduce strain on the surgical site.

- Gentle Exercise: Engage in gentle range-of-motion exercises as recommended by your healthcare provider. This can help maintain mobility and reduce stiffness without overexerting the area.

- Monitor for Symptoms: Be vigilant for any signs of infection (such as increased redness, warmth, or discharge) or significant swelling. If you notice any concerning symptoms, contact your healthcare provider promptly.

- Compression Garments: Wearing a compression garment may help manage swelling and provide support to the area. Discuss this option with your healthcare provider.

- Skin Care: Keep the skin in the affected area clean and moisturized to prevent irritation and infection.

- Avoid Tight Clothing: Wear loose-fitting clothing to avoid unnecessary pressure on the surgical site.

In conclusion, while fluid accumulation and pain in the axillary region post-surgery can be distressing, they are not uncommon. It is essential to maintain open communication with your healthcare team regarding your symptoms and any concerns you may have. Regular follow-ups can help monitor your recovery and address any complications early on. If the seroma persists or worsens, further evaluation and management may be necessary. Always follow the specific advice of your healthcare provider tailored to your unique situation.

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