Examples of complications
Complications are an inevitable part of medical treatment (Figures 13.1,13.2,13.3,13.4,13.5,13.6,13.7,13.8,13.9,13.10,13.11,13.12,13.13,13.14,13.15,13.16,13.17,13.18,13.19,13.20,13.21). Awareness of possible complications should allow all possible measures to minimize their occurrence. Open discussion with patients allows a realistic expectation of outcome and informed consent to treatment.
Drainage of a seroma following latissimus dorsi flap breast reconstruction. Seroma formation is also common after axillary clearance surgery and mastectomy.
Mild asymmetry of the breasts following conservation therapy for a right-sided breast cancer. There is also telangiectasia around the wound area where a radiotherapy boost has been given.
Poor cosmetic result following wide excision of a cancer of the lower inner quadrant of the left breast.
Lymphoedema of the breast after conservation therapy. The breast is swollen and slightly erythematous with oedema. This appearance is not uncommon following treatment of breast cancer by wide excision and radiotherapy, particularly after axillary clearance surgery, and an upper outer quadrant tumour in a large breast. Peau d'orange due to underlying malignancy can have a similar appearance.
A: Large axillary dog ear following mastectomy. These can be a nuisance for patients and may require excision (as in this case). B: Dog ear at the lateral end of the scar from harvesting of a latissimus dorsi flap.
Lymphoedema of the left arm following axillary node clearance surgery. At least 10% of those undergoing axillary clearance are affected by lymphoedema to some degree. Physiotherapy and compression garments can be useful.
After axillary surgery, cording, with a tight strand across the axilla (or occasionally elsewhere) probably due to thrombosis of lymphatics can be seen. It resolves spontaneously over a few weeks.
Ulceration of the skin with underlying necrosis due to radiotherapy following breast cancer treatment. This can be difficult to manage, requiring wide excision and flap coverage, but is now rare.
Hair loss is expected during anthracycline and taxane chemotherapy commonly used for breast cancer. Patients can be provided with wigs in a ...