Potential complications with Oncoplastic Breast Surgery and the short-term side effects
Breast cancer patients may be weighing up the surgery possibilities. Traditional breast cancer treatment options such as a mastectomy or a lumpectomy can leave undesirable cosmetic outcomes. However, Oncoplastic Breast Surgery is a breast-conserving surgery combining breast cancer removal and immediate reconstruction into a single procedure.
Oncoplastic surgery may be preferable for a patient seeking more favourable cosmetic outcomes and better recovery, with no compromise on the efficacy of breast cancer removal. The single procedure is less traumatic, and the patient can benefit from surgical oncology with immediate breast reconstruction; instead of returning for a second cosmetic surgery. However, like any breast cancer surgery, there are potential complications and side effects. Here, we will cover all of the possible complications and side effects associated with oncoplastic surgery so patients can understand the relative risk of this procedure.
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- What are the potential side effects of Oncoplastic Breast Surgery?
- Potential postoperative complications of Oncoplastic Breast Surgery
- Additional risk factors for Oncoplastic Breast Surgery Complications
- Complication risk with Oncoplastic Breast Surgery compared to other procedures
What are the potential side effects of Oncoplastic Breast Surgery?
Even with successful oncoplastic breast surgery, the procedure may have some side effects. Here we cover some common side effects, including what to expect and when to be concerned/contact your plastic surgeon.
- Pain is normal to experience severe pain for the first few days post-surgery; this will be manageable with pain relief; however, any severe pain that lasts longer than a few days may be a sign of a more severe complication.
- Swelling & Seroma – Swelling at the surgery site is completely normal; however, some patients may experience excessive fluid build-up (seroma). Light compression clothing can help reduce this swelling – in severe cases, contact your breast surgeon.
- Nerve pain – after breast cancer removal and reconstructive surgery, it is not uncommon for patients to experience nerve pain such as itching, burning or shooting pains in the breast. Nerve pain may take up to 12 months to settle down.
- Loss or change in sensation – a loss/change in breast sensations is less likely with oncoplastic breast-conserving surgery. However, patients can experience a change or loss of sensation, particularly in a reduction mammoplasty procedure.
- Reduction in breast size – for patients who undergo adjuvant radiation therapy after Oncoplastic Surgery, some shrinkage of breast volume is normal.
Potential postoperative complications after Oncoplastic breast surgery
While many undergo successful breast cancer surgeries, some patients may experience surgical complications of some kind, although severe complications are considered rare. It is worth being aware of possible surgical complications and the signs to look out for.
- Internal bleeding/bleeding under the skin (haematoma) – a haematoma is usually not a serious complication and can be treated at home with light compression clothing and/or a heated pad.
- Wound complications – it is rare that the patient’s wound/sutures will open, but if this occurs, the patient should contact their plastic surgeon immediately.
- Infection – if the patient experiences excessive pain, swelling, fever, temperature, or pus at the surgery site, these are all signs of an infection and will need medical attention from their surgeon or medical professional.
- Deep vein thrombosis (blood clot) – some people are more prone to blood clotting. Some signs of a blood clot include new shortness of breath, excessive chest pain, tightness, or discolouration/swelling in the arms or legs. Contact your surgeon if you suspect you may have a blood clot.
- Perforator flap failure/loss – the vascularised tissue used for oncoplastic breast reconstruction may be lost due to blood supply issues. In this rare case, the patient will need surgical intervention.
- Fat necrosis – in rare cases, fat tissue could die due to poor blood supply. Surgical intervention may not be necessary. However, the breast tissue may be left feeling lumpy.
- Seroma – a severe seroma – where extreme swelling and fluid build-up causes pain and discomfort – may need surgical intervention. However, draining a seroma is a relatively simple procedure.
- Positive margins – it is possible that cancer cells remain in the surrounding breast tissue. For this reason, we recommend that all patients undergo adjuvant radiation therapy to decrease the possibility of invasive breast cancer resurgence.
Additional risk factors for Oncoplastic Breast Surgery complications
Certain additional factors may increase the possibility of surgical complications associated with Oncoplastic Surgery. If you are concerned that any additional risk factors apply to you, contact your surgeon to discuss procedure suitability. Possible risk factors include:
- Pulmonary disease – suffering from pulmonary disease may increase the risks of surgical complications, including blood clots.
- Age – one of the only factors significantly positively correlated with breast surgery complications is age. Older women may find the recovery process challenging. The Oncoplastic technique may be the preferred surgical procedure as recovery tends to be better.
- Diabetes – Patients with diabetes may also find recovery more challenging. Oncoplastic Breast Surgery may be the preferred approach as recovery is usually faster.
- Vascular disease – VD could increase the chance of blood flow complications during and after surgery; possible associated complications are fat necrosis, deep vein thrombosis or perforator failure/loss.
- Hypertension – Oncoplastic Breast Surgery may be more complicated for patients with high blood pressure; these patients require close monitoring.
- Prior breast surgery – Having undergone prior breast surgery could mean that the breast tissue is already scarred; this could complicate recovery or the surgical procedure.
- BMI – a Body Mass Index that is too high or too low may be associated with additional surgical and recovery risks. Too high and the risk of postoperative complications may be higher; too low and breast size may not be suitable for cancer removal with immediate reconstruction. Women with a higher BMI may be better suited to therapeutic mammoplasty (an oncoplastic breast reduction).
Complication risk with Oncoplastic Breast Surgery compared to other procedures
Breast Conservation Surgeries have been associated with a lower risk of surgical and postoperative complications than mastectomy with reconstruction. Oncoplastic Breast Surgery is also considered equally safe compared to alternative breast conservation surgeries, such as a lumpectomy; even despite the longer single surgery duration.
Additionally, Oncoplastic Surgery is equally if not more effective at removing breast cancer tissue compared to simple lumpectomy. Due to soft tissue replacement, characteristic of Oncoplastic Breast Surgery, greater tissue margins surrounding the tumour can be removed without significantly impacting aesthetic outcomes or recovery.
However, it may be more important to consider patient suitability when it comes to therapeutic mammoplasty procedures, where tumour removal is combined with a breast reduction. The risks associated with therapeutic mammoplasty are higher. If you are interested in discussing your breast cancer treatment options, get in touch with Stephen McCulley to find out which Oncoplastic Breast Surgery procedure would be the best option for you.