Complications following breast cancer operations

COMPLICATIONS FOLLOWING BREAST CANCER OPERATIONS

Haematoma
A haematoma is a collection of blood which leaks from the tissues during or after an operation and is unable to escape. Blood may collect under the skin flaps which remain after a breast operation, although this is uncommon if the surgeon has taken care to stop bleeding during surgery. The drainage tubes which are inserted into the breast are left in place until there is no further seepage of blood or fluid.
Some surgeons ask for the arm on the affected side to be kept bandaged to the side of the body to reduce the risk of haematomas forming in the axilla. If this is done, it may make breathing
exercises more difficult.

Pyrexia
Pyrexia is simply fever, which can occur during the first 24 hours after an operation. The cause of a persistent fever may need to be investigated, and is most likely to be a chest or wound infection or deep vein thrombosis.
Wound infection
Infection can occur in the breast wound, which will become red, hard and tender, possibly discharging pus if an abscess has formed. Wound infection can cause fever and sweating and may make you feel generally unwell. Abscesses can normally be treated effectively by releasing the pus they contain and by a course of antibiotics.
When a large area of skin has been removed, and the remaining skin flaps cannot be pulled together easily, a skin graft may be necessary to fill the gap. If the edges of the skin flaps are pulled together too tightly, they may die and healing can be delayed. It is also possible, but rare, for gangrene to develop if the blood supply to the edges of the skin is cut off. The skin may turn black, or it may swell and become inflamed. If this occurs, immediate treatment will be necessary to remove the dead tissue and replace it with a skin graft.

Fluid collection
Fluid collection is common following wide lump excisions and mastectomies. The fluid may need to be aspirated repeatedly, and the condition can be extremely uncomfortable. Do seek your doctor's advice as soon as possible if the fluid collects quickly after aspiration.
The skin flaps resulting after breast tissue has been removed often become raised by a collection of fluid which forms a seroma. A seroma can develop despite the use of drains to withdraw fluid from the operation site. Some fluid probably comes from the lymphatics and from the bare muscle exposed when a breast has been removed. The fluid is usually a light golden colour, and not bloody. Although seromas can be persistent, the collected fluid can simply be drawn off via a needle inserted painlessly through the scar.

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