Very old seroma - looking for info before planning more surgery

I am a 57-year-old breast cancer survivor.  I was diagnosed in early 2008 and elected for breast preservation and had a partical mastectomy (needed a second one to get clear margins).  I had infiltrating invasive cancer, and the area removed was about the size of a golf ball.  A sentinal node biopsy showed two ancillary nodes were cancerous, so all the remaining ones were removed, they were all free of cancer. This was followed by six rounds of chemo and later 47 days of radiation.  

I have been plagued by having a seroma which does not go away.  My surgeon was reluctant at first to drain it due to risk of infection, but it became more and more uncomfortable and finally I decided to have it drained.  I have had this done two or three times a year for over two years.  Recently it had become so uncomfortable that the pain made it difficult for me to sleep, and all day long I was aware of any movement of my arm causing discomfort/pain in my breast.

Each time I go for aspiration, about 110 - 120 cc of yellow fliud is removed.  We hoped that over time the amount would lesson, but that has not happened.  My breast surgeon feels that the radiation affected the tissue surrounding the seroma so that the fluid is not able to be reabsorbed naturally.  

He told me a few days ago when I had it drained that he never had a patient like me in his 30 years of surgery!  He has been recommending a surgery in which he would somehow roughen the tissue and then apply talc to help the sides of the serome stick together, then put in a drain to be kept in as long as I can stand it. He cannot guarantee that this will solve the problem, but I finally feel that this situation has gone on too long and I should consider the surgery he suggests.

Does anyone have experience with a long-lasting seroma and with this type of surgery?  Would this be as painful as the initial surgery? I will be seeing him again soon to discuss the surgery in more detail and I want to know what questions to ask and what results others have gotten.  I also want to know how to find out who to go to for a second opinion.

Thank you for your suggestions and support.

Lorr

[Paderla Anitha, DNB]

Hello and hope you are doing well.

As the seroma is recurring, surgery may be the option. But there is the likelihood of excessive bleeding due to the fibrous tissue surrounding the lesion. The surgery may not be as extensive as the initial surgery and hence less painful.

Hope this helped and do keep us posted.