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Dr. Linder's Blog

LONG-TERM SEROMA

Posted On: April 01, 2014 Author: Dr. Stuart Linder Posted In: Uncategorized

 

STATUS POST MAMMOGRAM TRAUMA – LEFT BREAST

This patient presents with a very swollen and painful left breast that has endured a 10-month history of having had a mammogram and pulling on the breast with severe tearing of the left medial pectoralis muscle tendon and the inframammary fold.

On examination, the patient has a severely painful and swollen left breast.  There is venous dilatation and dilation of the veins around the left areola and great asymmetry compared to the right.   She went to surgery and underwent exploration of the left breast with evacuation of 300 cc yellow seroma with identification of two large tears with small blood clots in the medial upper muscle tendon of the pectoralis major muscle as well as two separate small blood clots along the left inframammary fold.  These areas were cleaned, irrigated with antibiotic solution and coagulated as necessary.  As you can see in the video, there is a significant amount of yellow chronic serous fluid with breakdown in protein associated with this traumatic double tear of her left breast.  Seromas like this should not wait a year to be drained.  They should be drained as soon as possible to prevent further tissue damage as has occurred in this patient with complete tearing of the upper medial muscle as well as the inframammary fold.  There were blood clots that had to be cleansed and resolved.  These patients are at an increased risk for recurrent scar tissue and capsular contracture.

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