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Had Stereotactic Breast Biopsy. Had Large Hematoma At Surgical Site. Had Bruising And Tingling. Have Soreness In Breast

Posted on Mon, 28 Oct 2013

Question: I had a stereotactic breast biopsy on what was a benign lymph node. They hit a blood vessel. It was very painful and I had a large hematoma at the surgical site, which was the upper outter area. I had some bruising and tingling in the lower inner area of my breast also, which eventually turned into a spot of redness and swelling. Its been 9 weeks and the hematoma is all but gone but the redness and swelling does not seem to leave. I still get soreness in my breast and what feels like nerve tingling in the red area. My surgeon put me on cipro for 10 days in which some of the swelling may have gone down but it didnt make a large difference. He thinks it is just part of the healing process and since I have large breasts that it will take longer to heal. I have anxiety and have been worried about inflamatory cancer or lymphedema. The doctor wants to monitor the situation for a month and see if it improves. Its strange to me that this redness is not in the area of the surgical procedure but lower. Im just worried my doctor isnt doing enough if this is XXXXXXX

Answered by Dr. Krishna Kiran Kannepalli (42 minutes later)

Brief Answer:
The hematoma might have tracked.

Detailed Answer:
Hi! Thanks for the query. You mentioned in your question that you underwent a stereotactic biopsy. A mammogram must have been done before the procedure. If there were a lesion in the inner half it would have been picked up on the mammo. The fact that the redness appeared after the procedure rules out the diagnosis of inflammatory cancer. Lymphedema is also very unusual after a stereotactic biopsy. I suggest you to wait it out till the hematoma resolves completely as suggested by your doctor. The swelling and redness in the inner half might be due to the hematoma tracking into that area. An ultrasound of the affected area will be helpful I'm differentiating between a hematoma and a tumor.

Available for follow up queries if any.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Krishna Kiran Kannepalli (8 days later)

I have read that lesions don't always show up on mammography when Inflamatory Breast Cancer is involved, but yes there was a mammogram and ultrasound done. I also suspected it may be lymph fluid because of the removal of a lymph node during the biopsy. Is it a normal occurance to have redness and swelling so many weeks after a biopsy not at the biopsy site? The hematoma that was at the surgical site is completely healed however the redness and swelling on the lower part of the breast is not.

Answered by Dr. Krishna Kiran Kannepalli (2 days later)

Brief Answer:
Inflammatory breast can never diagnosed on mammo

Detailed Answer:
Inflammatory breast cancer is a clinical diagnosis. It is never diagnosed based on mammo findings. It is diagnosed when more than one third of the skin overlying the breast is involved and not when there is a localized area of involvement. Sometimes hematomas take weeks to resolve. I can understand your anxiety .

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Krishna Kiran Kannepalli (6 days later)

My surgeon sent me for an ultrasound which came back negative for abnormalities so he did a skin biopsy on Thursday. Now of course my swelling is worse. He thinks IBC after a biopsy like mine would be very unlikely, but that the biopsy would let him know if there is a hard to treat infection in the tissue. After the biopsy he said that it was very superficial swelling and just looks like inflamation to him. Do you think lymphedema could be a cause for this redness and swelling? Im still worried about possible Inflamatory Breast Cancer.

Answered by Dr. Krishna Kiran Kannepalli (1 hour later)

Brief Answer:
I dont think its lymphedema.

Detailed Answer:
Hi,

Thanks for the query.

As I mentioned earlier, IBC is a clinical diagnosis. A skin biopsy is helpful but in the absence of corroborative clinical findings, it is still not diagnosed as IBC. Lyphedema more often affects the arm and not the breast. I hope I have answered your question. Please feel free to ask if you have any doubts.

We will be happy to answer you.

Regards,

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Above answer was peer-reviewed by : Dr. Raju A.T