Breast reconstruction surgery

Introduction

• Breast lumps are a common symptom in premenopausal women.
• Most breast lumps are benign.
• A lumpectomy for a breast lump can definitively diagnose the lump's pathology and control symptoms.

Surgical procedure

1. The surgery will be performed under general or local anaesthesia.
2. The surgical incision is located on the breast skin.
3. The location of the lesion can be determined by palpation, ultrasound or stereotaxy.
4. If a lesion is localised in the radiology department before surgery, a skin marker/wire/isotope will be injected into the breast. These injections will be removed along with the specimen during surgery.
5. Excision of abnormal breast tissue
6. Ultrasound or mammography may be used to examine the sample to determine if the lesion has been completely removed.
7. To stitch a wound closed

Risk
Anaesthetic complications

General anaesthetic

1. Cardiovascular complications: myocardial infarction or ischaemia, stroke, deep vein thrombosis, pulmonary embolism, etc.
2. Respiratory complications, atelectasis, pneumonia, asthma exacerbation, exacerbation of chronic obstructive airway disease
3. Allergic reactions and shock

Local anaesthetic

1. Local anaesthetic injected into the operative site
2. Even in extremely rare circumstances, the toxicity of local anaesthetics can cause serious complications
3. Surgical complications (potential complications are not exhaustive)

Common surgical complications

1. The wound is painful
2. Wound infection
3. Bleeding (further surgery may be required to remove blood clots)
4. Hypertrophic scars or keloids can result in unsightly scarring.
5. Radioactive isotopes contain small amounts of radioactive material and pose a relatively low risk to the human body, with the exception of pregnant women.

After surgery, most of the radioactive material is removed along with the tissue samples, so only a very small amount of radioactivity remains in the body.

6. In extremely rare cases, allergic reactions can occur when using radiopharmaceuticals.
7. Not all lesions were completely excised.
8. Failed to accurately locate the lesion, surgical excision failed

Pre-operative preparation

1. Prepare for surgery in accordance with non-emergency surgical procedures
2. Surgery on the day of admission or the following day.
3. For general anaesthesia, a pre-anaesthetic check-up must be performed before the operation.
4. If you are preparing for general anaesthesia, you must fast for 6 to 8 hours before the operation.
5. Patients may need to go to the X-ray department for isotope injection for pre-operative imaging and localisation.
6. Change into a surgical gown before being taken to the operating theatre.
7. Pre-medication and intravenous infusion may be required.
8. Antibiotics may be required, either by injection or orally, to prevent or treat infection.
9. Please inform the doctor of any drug allergies, regular medications, or medical conditions.

Post-operative instructions
After surgery, generally, you will experience

1. Mild discomfort in the throat caused by the insertion of a nasogastric tube.
2. You may experience mild discomfort or pain at the surgical site. If the pain intensifies, please inform the nurse or doctor.
3. When undergoing general anaesthesia, nausea or vomiting can occur. If symptoms are severe, you should inform the nurse.
4. If you require more painkillers, please ask the nurse.
5. You can be discharged home on the day of surgery or the following day.

Wound care

1. Patients can shower on the first day after surgery, but should be careful to avoid wetting the wound area (keep the wound dressing dry).
2. Sutures or clips (if present) can be removed in 10 to 14 days.

Food and drink
You can resume eating and drinking after awakening from anaesthesia.

Post-discharge instructions
If any of the following events occur, please contact your doctor or go to the emergency room.

• Worsening pain or redness of the wound
• The wound is leaking.

When necessary, take painkillers prescribed by a doctor
Gradually resume daily activities according to personal circumstances

Follow-up management
Following a pathological diagnosis of the sample, further surgical treatment may be required.

Relapse
Breast lumps are common lesions and recurrences are also quite common. New breast lumps can be found in either breast.

Notes
This leaflet provides only basic information about the surgery, and not all possible risks or complications can be listed. The level of risk also differs for individual patients. Please contact your doctor if you have any questions.

Source: https://www.ekg.org.hk/pilic/public/surgery_pilic/surgery_breastlumpexcision_0200_chi.pdf