Scar tissue after lumpectomy

  • Abdominal Pain
  • Addiction
  • Allergic Reactions
  • Anemia
  • Anxiety
  • Appetite Changes
  • Armpit Discomfort
  • Axillary Web Syndrome (Cording)
  • Back Pain
  • Bleeding and Bruising Problems
  • Blood Clots and Phlebitis
  • Bone and Joint Pain
  • Breathing Problems
  • Chest Pain
  • Cold and Flu Symptoms
  • Constipation
  • Coughing
  • Dehydration
  • Delayed Wound Healing
  • Depression
  • Diarrhea
  • Dizziness
  • Dry Mouth
  • Dry Skin
  • Electrolyte Imbalance
  • Endometrial Cancer
  • Endometriosis
  • Fainting
  • Fatigue
  • Fertility Issues
  • Fever
  • Gas (Flatulence)
  • Hair Changes
  • Hand-Foot Syndrome (HFS) or Palmar-Plantar Erythrodysesthesia (PPE)
  • Headaches
  • Hearing Problems
  • Heart Problems
  • Heartburn or Gastro-Esophageal Reflux Disease (GERD)
  • Hematoma (Blood Build-Up)
  • High Blood Pressure (Hypertension)
  • High Cholesterol
  • Hot Flashes
  • Infection
  • Insomnia (Trouble Sleeping)
  • Itching
  • Kidney Problems
  • Leg Cramps
  • Liver Problems (Hepatotoxicity)
  • Loss of Libido
  • Low Blood Pressure (Hypotension)
  • Low White Blood Cell Count
  • Lung Problems
  • Lymphedema
  • Memory Loss
  • Menopause and Menopausal Symptoms
  • Mood Swings
  • Mouth and Throat Sores (Mucositis)
  • Muscle Pain (Myalgia)
  • Nail Changes
  • Nausea
  • Neuropathy
  • Nosebleeds
  • Numbness
  • Osteonecrosis of the Jaw
  • Osteoporosis (Bone Loss)
  • Pain
  • Phantom Breast Pain
  • Post-Traumatic Stress Disorder (PTSD)
  • Rash
  • Runny Nose
  • Scar Tissue Formation
  • Seroma (Fluid Build-Up)
  • Skin Discoloration
  • Skin Sensitivity
  • Sore Throat
  • Stroke
  • Swallowing Problems
  • Sweating
  • Swelling
  • Taste and Smell Changes
  • Urinary Tract Infection (UTI)
  • Urine Discoloration
  • Vaginal Discharge
  • Vaginal Dryness
  • Vision and Eye Problems
  • Vomiting
  • Weakness
  • Weight Changes
  • Research News on Side Effects

Breast cancer

Blood clots

After surgery, you’re at risk of blood clots developing in your legs. There is also a small risk of a blood clot in your lungs.

To prevent blood clots, your nurses get you up as soon as possible after your operation. They encourage you to move around or do your leg exercises.

Also, during and after your operation, you wear special stockings (called anti embolism stockings or TEDS). And after your operation you might have injections to thin your blood for a while.

Tell your doctor straight away or go to A&E if you:

  • have a painful, red, swollen leg, which may feel warm to touch
  • are breathless
  • have pain in your chest or upper back
  • cough up blood

Bleeding from the wound

You may have a small amount of blood on your wound dressing after surgery, which is normal. Your nurse will regularly check your dressing after the operation. Tell your doctor or nurse straight away if there is more bleeding.

Wound infection

Tell your doctor or nurse if your wound:

  • looks red or swollen
  • feels warm
  • is painful
  • leaks fluid (discharge)

These are signs of infection. You may also feel unwell and have a temperature.

If you have an infection, your doctor will give you antibiotics. You might need to go into hospital if you need antibiotics through a drip.

Fluid collecting around the operation site (seroma)

Sometimes fluid collects near the wound. This might happen after your nurse removes the wound drain, if you have one.

It can cause:

  • swelling
  • pain
  • an increased risk of infection

The fluid normally goes away on its own within a few weeks. For some people, this can take up to a few months after surgery.

If the seroma is painful, your nurse can drain the fluid with a needle and syringe.

Tell your doctor or nurse if you think a seroma is developing.

Blood collecting around the operation site (haematoma)

Occasionally blood collects in the tissues around the wound. This can cause pain and swelling, and the area might feel hard.

The haematoma normally goes away on its own but it can take a few months. Your doctor or nurse can drain the swelling if needed.

Tell your doctor or nurse if you have any swelling around the wound.

Nerve pain

You might have numbness, tingling or a shooting pain in your armpit, upper arm, shoulder or chest wall. This is due to damage to the nerves during surgery.

The nerves usually repair themselves but it can take many weeks or months.

Your doctor or nurse can give you medicines to help with nerve pain.

Shoulder stiffness

Your shoulder might become stiff and painful after breast surgery or removal of the lymph nodes.

Your nurse or a physiotherapist will show you exercises to do after your operation to help improve movement in the shoulder.

A swollen arm or hand

You might have some slight swelling in your arm or hand after your operation. This is normal but it should go away if you do the regular exercises to help with stiffness in your shoulder.

Tell your doctor or nurse as soon as possible if you get a lot of swelling, pain, or tenderness in your arm or hand.

You are at risk of long term swelling (lymphoedema) in your hand and arm after surgery to remove your lymph glands. This is swelling caused by lymph fluid that can’t drain away. It can happen any time after surgery.

Once you have lymphoedema it can’t be cured but early treatment can help to control it. Your nurse will talk to you about ways of preventing lymphoedema.

Problems after lymph node removal

If you had lymph nodes removed, you might have other problems after surgery.

Kathy’s Story

Name:

Kathy

State:

Michigan

Date of diagnosis:

1993, June, 2012

Age at time of diagnosis:

46 and 64

Stage of diagnosis:

Stage 2 and Stage 4

Date of ‘NORMAL’ mammogram:

Within the year

How was cancer diagnosed: By me as I had changes in scar tissue at lumpectomy site/Ultrasound and MRI confirmed Stage 4 with mets to bones, pelvic, abdomen and lungs

Kathy’s story: My story goes back to when I was premenopausal and 46 years old. The mammogram detected a 2.5 cm tumor. I had a lumpectomy and was treated with chemotherapy and radiation. I also was on Tamoxifen for 5 years; I thought I was okay. Unknown to me was that I had dense breast tissue and not one of my health care providers ever talked to me about the significance of this fact.

I had yearly mammograms for nearly 20 years after my diagnosis. I complained about the size and shape of the scar tissue from the lumpectomy site from 2009 till 2012. No one listened or was alarmed and no one did a clinical breast exam. I was simply told the mammogram said ” normal” and adjunct screening was never discussed. I was naïve too, because I didn’t know I could have asked for more testing beyond the mammogram. Again, no one ever said anything about my breasts being dense.

I knew that I needed to find another breast surgeon who would listen to me. I did when I was visiting in Florida. As I showed my doctor the scar tissue at the lumpectomy site, he told me to go back to Michigan, find an new breast surgeon and have an ultrasound and MRI. As I was preparing for my visits with my new surgeon, I got copies of my 5 years of mammography reports written by my radiologist – the words DENSE kept coming up in each report.

Tragically, the ultrasound and MRI confirmed a 7.6 cm cancer on the right side (where I had my prior lumpectomy) and 5 small tumors on the left – metastatic stage 4 breast cancer with pleural effusion by each lung and tumors on the liver, lungs, and in the bones and left inguinal area, umbilical area and abdomen.

I was angry that after all my complaints my health care providers dismissed my concerns because of my normal mammograms. I don’t and will never trust the local and regional radiologists as they need more training. Having the opportunity to have adjunct screening to mammography, because of my dense breast tissue and my risk factor of already having breast cancer, was NEVER discussed with me.

I had to make a decision to move on with life, because of its shortness. I am educating others to be their own advocate, as many women are misinformed and ill advised about the impact of dense breast tissue on breast health, or don’t know how to be their own advocate. I have two daughters that I am also educating and hopefully they will be empowered about their dense tissue and breast health.

I do not want to frighten other women but there is a message in my story. It is about knowledge of density and its significance.

What Is a Lumpectomy?

Even though it’s the least-invasive breast cancer surgery, a lumpectomy can be very effective.

If you’ve been diagnosed with breast cancer, your doctor may recommend a lumpectomy as a method of treatment.

A lumpectomy is considered a breast-conserving surgery because, rather than removing an entire breast (as in a mastectomy), the surgeon removes just the area of the breast where there is cancer.

This technique allows surgeons to maintain the appearance of your breast as much as possible.

A lumpectomy can be very effective even though it’s the least-invasive form of breast cancer surgery. In some cases, the procedure can prevent the need for further surgery.

When Is a Lumpectomy Performed?

Your doctor may recommend a lumpectomy if you have been diagnosed with early-stage breast cancer, or to remove certain noncancerous or precancerous breast abnormalities.

You may not be a good candidate for a lumpectomy if you have any of the following:

  • Scleroderma, which hardens the skin and other tissues, making healing after a lumpectomy difficult
  • Systemic lupus erythematosus (SLE), a chronic inflammatory disease that can get worse from radiation
  • Several tumors in different areas of your breast that would require more than one incision
  • Past radiation treatments in the same breast region, which would make more radiation treatments risky
  • Cancer that has spread throughout your breast and overlying skin
  • A tumor that is large compared with your breasts, so that removing the tumor would leave a poor cosmetic result

What Happens in a Lumpectomy?

A lumpectomy is often performed under general anesthesia, which means that you’re unconscious during the procedure.

The surgeon makes an incision in the breast and removes the tumor, along with a small portion of tissue around the tumor, to make sure that all of the cancer is removed.

The surgeon may also make an incision in the underarm area and remove some lymph nodes.

At the end of the surgery, your doctor will close the incisions with stitches.

A lumpectomy is often followed by radiation therapy to reduce the risk of the cancer’s returning.

Lumpectomy Risks and Side Effects

The following side effects can occur after a lumpectomy:

  • Soreness in your chest, underarm, and shoulder
  • Numbness around the surgical incision
  • Bleeding
  • Infection
  • Pain
  • Swelling
  • Tenderness
  • Hard scar tissue (keloid) where the surgery took place
  • Changes in the shape and appearance of your breast, particularly if a large portion was removed
  • Numbness and swelling in your arm (called lymphedema) if you had lymph nodes removed

Reconstruction Surgery

Breast reconstruction surgery can help rebuild your breast after a lumpectomy so that it looks similar to its appearance before the lumpectomy.

In this procedure, either a silicone implant or the body’s own tissue from the abdomen, back, thighs, or buttocks (called a tissue flap) is used to give the breast its shape.

The surgery includes reconstructing the nipple and areola, if needed.

Caring for scars after breast cancer surgery

People often call our Helpline asking how to look after their scars following breast cancer surgery.

They are concerned for various reasons. For example, their scars may feel tight and be causing pain and itching. Sometimes people are unhappy about how their scars look.

What are scars and how are they formed?

Scars are a natural part of the body’s healing process. All breast surgery will leave some scarring but it’ll be different for each person.

After breast cancer surgery, wound healing is helped by the formation of new collagen for around three months. The blood supply to the area increases, causing the scar to become raised, lumpy and red.

Then, as some of the collagen at the wound site starts to break down and the blood supply reduces, the scar gradually becomes smoother, softer and paler. This takes many months.

In some cases the body can produce too much collagen causing scars that are more raised than usual. Such scars are called hypertrophic and can take several years to settle.

A keloid scar is similar to a hypertrophic scar but it continues to grow, increasing in height and spreading over normal tissue even after it has healed. The scar may be painful, tender and itchy.

Both of these kinds of scars are more common in younger and dark-skinned people.

Are there treatments for scars?

There isn’t a treatment that can remove scars, but there are some things that may help reduce them or improve their feel and appearance. Again, the success of a treatment will depend on your individual case.

Your surgeon will have ideas about the best treatment for you.

Your hospital team or breast care nurse will be able to discuss your concerns and expectations, and suggest what treatments might be used to improve your scars. Some treatments are listed below.

  • Silicone gel sheets and silicone gel may help to heal a scar, reducing its size and colour, and making it feel softer. The sheet or gel covers the scar and moisturises it. You can get silicone gel products through your GP (local doctor) or hospital team on prescription, or buy it direct from pharmacies.
  • Steroid injections can help to soften and flatten hypertrophic and keloid scars. They may also reduce any pain and itching caused by the scar.
  • Pressure treatment with an individually tailored elastic garment may help reduce a scar.
  • Surgery can remove scar tissue but will also make new scar tissue.
  • Cosmetic camouflage can help to conceal a scar.

Care tips

Callers often ask what type of cream they should use to moisturise the scar area. Any emollient cream or oil is suitable.

The type you use will not have a direct effect on your scar but massaging moisturiser into the scar will keep it from becoming dry and helps to make it supple.

Scars, especially new ones, are sun sensitive. Use sunscreen for protection.

Tight clothing can irritate or injure scar tissue.

Continuing with your post operative exercises is really beneficial for your arm and shoulder movement but take care during stretching because skin that has already been damaged is extremely sensitive.

Find out more about recovering after surgery

We’re here to help

If you want to speak to someone about this or any other breast health concern, call our free Helpline on 0808 800 6000.

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