surgical biopsy

[cls59]

Three weeks ago I had a surgical breast biopsy of tissue that looked suspicious. The results came back that everything checked out fine.  The problem is that I was left with alot of swelling, bruising and pain. I used ice packs for the first 48 hours. After three weeks I'm still deeply bruised and have a very large area (fits into the cup of my hand) that is swollen and hard. At my two week check up the Dr. said it probably was fuild (I did not have a drainage tube) and it would go away.  Do you think this is fluid of some sort or a hematoma? How long will this take to "go away"? I'm still having alot of pain!

[Anne0513]

quick question, I am having the same problem as the patient above (cls59) from a surgical breast biopsy, would carefully massaging the area or possibly ice or heat help the hematoma? Just wondering if there is anything I can do to help this area along or do I just have to wait for it to go away. Any risk with waiting? Thank you.

[CCF-RN,MSN-rf]

Dear cls59:  Sometimes when surgery is done, blood can accumulate within the breast.  This can look like a giant bruise.  As long as there is no fever and the breast is not "hot" to touch, then this is likely a hematoma that will resolve in time.  This could take weeks or months.  The only reason to do anything more invasive would be to relieve pain.  Sometimes some of the fluid can be drained.  One procedure will likely not be the only one needed.  The other option is to re-operate.  It will, in part, depend on how much pain you are having as to how to best approach the problem.  Glad that the biopsy was negative.

[surgeon]

It sometimes happens that there is bleeding after the incision is closed. This leads to very impressive bruising in some cases, and the accumulated blood can fill the hole where the biopsy was taken, and then some. As blood goes through the process of absorbing, the clot liquefies, and fluid is drawn into it, so the swelling and sense of contained liquid can actually increase with time. For the process to go completely away can take many weeks if the amount of blood is large enough. The reasons to intervene sooner, by draining it, are enough discomfort to warrant it, or infection. Sometimes a half-way between waiting forever, or fully opening it and cleaning it out is to drain the liquifying blood with a syringe. That takes several times. If it's going to be cleaned out, it usually means going to sleep, opening it up, irrigating it all out sterilly and re-closing. I've done all of the above, depending on circumstances.