Consent and Risks of Breast Surgery

Informed consent is an important part of any surgical procedure. Before your operation - I will explain what we are proposing in clear, straightforward language. This video outlines the aims of breast cancer surgery; the associated risks; and what the consent process involves. The primary aim of surgery for breast cancer is to remove the cancer, and stage the disease. Staging helps us understand how far the cancer has spread and guides further treatment decisions. Physically removing the cancer significantly reduces the chances of it returning in the future. If you are offered breast reconstruction, the aim is to restore the shape and volume of your breast. This can help improve your overall quality of life and confidence following treatment. The alternatives to surgery for breast cancer are often very limited. While other treatments such as chemotherapy, radiotherapy, and hormone therapy may be recommended, if the cancer is not physically removed - the likelihood of it recurring is typically higher. As a result - surgery remains the cornerstone of treatment. As with any operation, breast surgery carries some risks. Bleeding at the time of surgery or shortly afterwards can occasionally cause a collection of blood called a haematoma. This is uncommon, occurring in around one in every one hundred cases. Wound infections or related infections such as chest infections are also uncommon, occurring in approximately two to five in every one hundred cases. These infections are usually managed effectively with antibiotics when they do occur. All surgery involves scarring. In most people, scars heal well and flatten over time. However, some scars may become raised - which is known as hypertrophic scarring. A small number of people develop more prominent scarring called keloid scarring - which can sometimes require additional treatment. Pain following breast surgery is usually managed effectively with simple painkillers such as paracetamol and anti-inflammatory medications. A small number of patients may require stronger pain relief, but this is typically only needed for a short period, usually twenty-four to forty-eight hours. Altered sensation around the scar, particularly following surgery in the armpit area, is common. This usually improves over time, though in some cases changes in sensation may be permanent. Removing tissue from one breast can sometimes lead to asymmetry compared with the other side. Additionally, once the tissue has been analysed, a small number of patients may require a second operation called a re-excision. This is needed if the margins of the removed tissue are close, or involved. Breast surgery typically requires a general anaesthetic. The risks associated with general anaesthesia are very small. Common effects include a sore throat and some drowsiness afterwards. Chest infections are very uncommon, and serious complications are rare. Risks such as deep vein thrombosis and pulmonary embolism are also very rare. Your individual risk may be influenced by factors such as your body mass index, and smoking history. You will be given time to absorb information and ask questions before your operation. Both your consultant and clinical nurse specialist are available to support you through this process - and you may withdraw your consent at any time before the procedure. Understanding the risks of surgery is an important step in feeling prepared, and confident about your care. If you have any questions, your consultant and breast care nurse are here to help.