post-op question about medications (tamoxifen) and healing

[de77]

Hi,

I'd really appreciate any input from a doctor or person who might have had a similar experience as I.

I'm 2 months post surgery, sensation is returning to my chest, however my right nipple feels sore. IS THIS NORMAL? There is a hard mass directly behind the nipple which may or may not be gland tissue regrowth or scar tissue. It disappears when I apply pressure but reappears soon.

Given that the nipple is sore, could it possibly be gyne regrowth (my pubertal gyne was exacerbated by using hormonal supplements and I'm wondering if residual effects of the supplements might be lingering).

My estradiol levels shot up to 55 (range 11 - 44) before surgery and remained elevated up until 12 days post-op but then were normal.

I am thinking of running a one month cycle of tamoxifen just in case - could this in anyway be a bad idea? As far as my research it seems ok.

THANKS!

[Dr. Elliot Jacobs]

What you are describing (soreness/tenderness, the time frame as related to your surgery, etc) points more to development of some scar tissue rather than re-growth of breast tissue.  And if your estradiol levels are now normal, I don't think Tamoxifen would be helpful at this point -- if ever.

You are still in the active healing stage -- your body is busy healing, making and breaking down scar tissue, etc,  Would suggest continuing to wear a snug compression garment and some gentle massage to mobilize some residual swelling.

Down the road, if it persists, you might require a steroid injection to flatten it out.

Dr Jacobs

[de77]

Thank you for your response Doctor.

If the scar tissue persists, is it really as simple as an injection or two? That is heartwarming because I do not want to go through surgery again, in any case it seems like I heal poorly.

And I've been doing some digging and it seems I've uncovered a trend, tell me if you agree?
* Those with more scar tissue seem to have had more swelling post-op (and no drains), presumably this let fluid in between the skin and the muscle, allowing more scar tissue to develop over time?

In my own experience, I had lots of fluid drained out of my right side, which is giving me the problems now. Once a week for four weeks my doctor aspirated a syringe worth of fluid. The compression vest didn't have a chance, there was too much fluid that even with the vest on the area was bulging.

In hindsight I should have had drains put in and we should have aspirated more often.

[Dr. Elliot Jacobs]

Usually scar tissue is best treated with an injection or two.  I very rarely operate to remove scar tissue  because it is exceedingly difficult to get a smooth contour and also, and perhaps more importantly, you will just heal with more scar tissue.

Yes, it is generally true that if you have fluid or blood collection after surgery, there is a greater risk of developing scar tissue
 
Dr Jacobs