Here’s what a visible, palpable lump immediately after your mastectomy is most likely to be …

I recently underwent a preventive double mastectomy. Two and a half days later I removed the outer bandages and looked in the mirror.

Imagine my fear when I SAW what appeared to be a small lump about two inches above the mastectomy incision.

Why was there a lump immediately after my prophylactic mastectomy? It certainly had not been caused by the mere removal of the bandage!

I searched ferociously online and came up empty-handed. The lump did not meet the visible or causative criteria for a seroma and did not resemble a hematoma.

The lump above the mastectomy incision was discovered Saturday evening, so I had to wait till Monday to get an appointment.

My follow-up appointment with the surgeon had already been made for that Friday.

If you’ve discovered a lump that …
• You can see and feel (or only feel) right under your skin
• Is a few inches away from the mastectomy incision
• Immediately after the mastectomy (upon removing the gauze bandage)

… it is most likely the end of the drainage tube!

On Monday I got an appointment for the next day to have a nurse look at the lump.

When I pressed into it, it moved deeper, so I was not able to fully gauge how hard, rubbery or squishy it was, but the consistency felt like one of those fish oil gel caps or softgels, or almost like a grape.

It felt standalone, in that it didn’t taper into palpability, but suddenly was felt as I glided my finger along my skin.

In other words it had sudden borders about three-fourths the way around.

The nurse immediately thought it was the end of the drainage tube. She explained that even though the entrance into my skin for the drainage tube was nowhere near the lump, it was quite possible that the surgeon had extended it in that far.

She tried to track the tube from incision point to lump with her fingers and couldn’t find it.

She took an ultrasound and still believed that the lump was the end of the drainage tube. “I’m going to get the physician’s assistant for peace of mind,” she said.

He palpated the lump and then did an ultrasound, showing me the dark area that it represented. That was reassuring. “It’s not dense,” he said.

However, he wasn’t very sure what it was, either. He thought it was one of the four:

• Dilated blood vessel
• Seroma
• Dead fat tissue
• Hematoma (blood collection)

He was very positive that the lump was located IN the skin flap rather than entrenched in the muscle/fascia tissue below it.

The nurse who had made my appointment had speculated it was “healing tissue” and had no other explanation.

Lump Immediately After Mastectomy Is Drainage Tube

After the surgeon removed the drainage tube while I was lying with my eyes closed, I looked at the area where the lump was – and it was GONE. I also couldn’t feel it.

He told me that this was what he’d suspected after receiving the report from the nurse.

To avoid having to place two drains per side (four drains total), he typically feeds the drainage tube well into the chest area. More fluid is sucked out this way.

But what I couldn’t figure out was why the apparent size of the lump did not correspond to the diameter of the drainage tube.

He retrieved the entire tube from the waste can. Several inches of the embedded (hidden) portion was nearly twice the diameter of the visible portion.

It looked like two, slightly flattened tubes fused together, with a groove between them.

The shape and size correlated to what the lump felt like. I had him palpate the area just as added reassurance that I wasn’t imagining that the lump was gone. He said that an ultrasound would NOT show the tube.

So if you discover a lump under your skin, immediately after removing the gauze bandage of your mastectomy, consider the possibility that it’s the end of the drainage tube.

Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  
Top image: Shutterstock, Magnito