•    BLEEDING – It is common to have a slight bruise following any form of surgery.  To minimize this, the surgery is often performed using a diathermy (a type of cautery device).  Often a pressure dressing will be applied to the breast which is removed a day after surgery.  This aids in reduction of swelling and bruising.
•    INFECTION – As with any surgery, wound infection is a possibility.  To minimize this, prophylactic intravenous antibiotics are often given intraoperatively
•    SCARRING – Some scarring is to be expected with any surgery.  The incisions are usually placed either in skin creases (such as in the axilla) or in a circum-mammary fashion.  The skin tension lines around the breast often circle the breast in an onion ring-like fashion.  Placing incisions in these lines will minimize scarring.
•    DEFORMITY – With breast conservation, often a significant amount of breast tissue is removed, in order to obtain a good surgical clearance around the tumour.   This may result in a mild dimpling in the breast or perhaps a small indentation.
•    FURTHER SURGERY – With breast conservation, the aim of surgery is to obtain an adequate margin of excision (usually > 5-10 mm).  Unfortunately, this cannot be guaranteed and occasionally patients may need to return for further surgery when more tissue will need to be excised.  With respect to sentinel lymph node biopsy, further surgery may involve removing more lymph nodes if the sentinel node has been found to be involved with tumour (usually a formal axillary clearance).
•    NERVE INJURY/NUMBNESS – There is often a degree of numbness present around all surgical scars.  This is a result of small nerve fibers being severed under the skin during the dissection of the tumour.  With regards to the axilla, there are a number of nerves (intercostobrachial nerves) that can be damaged or severed during the procedure.  This will often lead to permanent numbness in the armpit, on the lateral chest wall and on the underside of the upper arm.  Some of this numbness may reduce over time but a permanent degree of numbness is to be expected.  The risk of injuring major nerves that control movements of the shoulder is quite low.
•    SHOULDER STIFFNESS – After axillary lymph node surgery a degree of discomfort is to be expected.  Many patients will be tempted to favour their arm and thereby not use their shoulder as much as normal.  Bearing in mind that most joints will become stiff after immobility, it is recommended that patients attempt some simple exercises within the first 24-48 hours to avoid the possibility of having long standing dysfunction of the shoulder joint.  In its extreme, this could lead to a “frozen shoulder”.  Patients who undergo an axillary clearance will usually be seen by a Physiotherapist on the Ward who will assist the patient in regaining normal shoulder movement.  Most patients will regain 90% or more of their normal shoulder movement following an axillary clearance by the first six weeks.  With a sentinel lymph node biopsy, the risk of significant shoulder stiffness is much reduced.
•    LYMPHOEDEMA (ARM SWELLING) – As the lymph nodes that drain the breast also drain the arm, significant lymph node surgery poses the risk of impeding the return of lymphatic fluid from the arm.  With a standard axillary clearance, the risk of developing arm swelling (lymphoedema) is anywhere between 10-30% at some stage in the patient’s life.  This can be very early or indeed very late (often years after surgery).  With the advent of sentinel lymph node biopsy, the risk of lymphoedema has reduced dramatically.  If lymphoedema was to occur, then early referral to a specialized lymphoedema Physiotherapist or Occupational Therapist is recommended as early treatment will often prevent the major disabling complications of severe lymphoedema.  Fortunately, in the modern era, severe lymphoedema is infrequently seen.
•    SEROMA (FLUID COLLECTION) – Following breast surgery, there is often a significant cavity left that will be filled by serum.  For most patients this is not noticeable and can be managed conservatively.  Following an axillary clearance it is very common to have an accumulation of fluid in the armpit after the armpit drain has been removed.  This usually requires a few visits to the Specialist to have this fluid aspirated (which fortunately is painless as there is some numbness of the armpit skin following surgery).  With sentinel lymph node biopsy the risk of seroma has reduced significantly.  Following a mastectomy, it is almost invariable for a moderate degree of fluid to collect under the mastectomy wound.  This is not a significant problem but will require a number of visits to the Specialist to have this aspirated.  Leaving drains in situ for longer will probably reduce the risk of a seroma, however this is tempered by the increased risk of a wound infection.  Usually drains are removed at about a week as a balance between seroma reduction and prevention of wound infection.
•    NEURALGIA (NERVE PAIN) – Some patients will have fleeting sharp pains on the chest wall or in the armpit following their surgery. This is as a result of bruising of nerves.  Often these nerves will develop neuropraxia (the nerve ceases to function) for six to eight weeks.  As they regain function, the nerves can sometimes produce electric shock-like pains.  In most patients, this will settle over a short period of time.

 

Patient Feedback

Thanks for all your words of support over the past year. You have truly helped me a lot in my recovery both medically and spiritually.

G

I know you might just be doing your job, but this woman certainly appreciates your kindness and professional attention!

S

Thank you very much for looking after me

J

Sincere thanks for your continued support & expert care

J

Thanks so much for your surgical care before, during and after the operation performed… For the entire process I always felt in good hands… I feel very well, the scarring is minimal and I’ll be returning to work in a few days.

J

There are no words that can convey how I feel except thank you from the bottom of my heart. I have always wanted to do this. My daughter was beside herself with shock as was I and you just listened to me rant on…I don’t know what the future holds for me but I will never forget your kindness and genuine concern.

J

Thank you for coming to my rescue… thank you for everything

B

Many thanks for your care this year

J

Thank you for your excellent care and brilliant surgical skills. I am very grateful to have been in your care

L

Thank you is just 2 small words but they mean a lot especially from my family & I to you.  I have so much to live for & I appreciate you giving me the opportunity to do so.

L

To the Wonderful Dr Vujovic Thank you for being exceptional! Despite my diagnosis…we feel completely at ease in your capable hands. [We] are once again extremely appreciative to have you as our surgeon.

E

Thank you for the care & support you have given me over the past 15 months.  It has been invaluable to me & I look forward to a continuation…

P

With deep gratitude for your help & support through [the year]

J

I would like to say thank you for helping me I really appreciate it and I am so grateful for your dedication to your work so you can help people like me.

K

Immeasurable gratitude for your extraordinary skill that delivered surgery without pain – unbelievable!  Ever indebted

B

…thanking you again for giving me such a lovely Christmas gift – my regained health” (J)

J

Thank you so much for your immediate attention to my condition. We appreciate it so much.

L

My sincere thanks for your wonderful skills during my stay at the PA.  Thanks!

B

Viva Vujovic!  Hail the masked artist working with scalpel and flesh sculpting amazons!

D

Thank you very much for all your help!

D & G

…thank you for a successful surgery!  Your warm & empathetic approach has made the experience much more pleasant.  I’m glad I came to you…and for choosing you as my surgeon.  This small gift has given me a new inspiration in life

M

I would just like to thank you ever so much for all the care you gave me throughout my journey to my full recovery.  I couldn’t have wished for a better Doctor and Surgeon to take care of me.  Thank you.

S

Petar thank you & all your team so much for putting me back on the straight & narrow…It has been greatly appreciated by all my family

G

[Thank you] for the study you did and the trials you went through to help a stranger like me. Takes a great man like you. The care I’ve had from everyone at the PA hospital has been amazing.

U

…I’m extremely grateful that you…took the time to see and treat me so quickly…

S

I cannot express my gratitude enough to you for the assistance you have given me over the past 6 or so weeks.  It has been quite difficult for me… Your efficiency, professional demeanour and understanding of my rather unorthodox situation, is most appreciated.  Your skill of surgery has been an exceptional choice…

L

Thank you for [notifying me of the results]… I’ve made an excellent recovery no doubt due to your surgery…

G

I just wanted to thank you again for your care and skill in helping me overcome the cancerous condition in my breast.  I am very grateful that this condition was diagnosed at such an early stage and that you could operate enabling me to have such a positive outlook.

J

Thanks so much for your wonderful bedside manner!!

V

Thank you for your prompt care. You are truly a God send!

G

Many thanks for your expert help during the past year. I am very grateful for your care & kindness

For saving my life thanks!

I am writing…to let you know how much I appreciate the thoughtfulness and care you showed towards me.  I really appreciated your understanding regarding the operation and the scar I would be left with from the operation and my overall well being…The operation was a success, the lump was removed and I had a nice and neat little scar around the edge of my nipple…Once again I would like to deeply thank you for the consideration you showed me towards my operation and the scaring I’d be left with.

S

Thank you so much for doing my operation. You were so kind and generous and making us understand what was going to happen to me.  Much appreciated.

M

…[I was] feeling so well after having received such care from you during my surgery in Brisbane…I have received individual comments from [the chief oncologist and radiologist] regarding the skill and efficiency applied to me during the surgery you gave me…isn’t it wonderful to be recognized and acknowledged by colleagues even though oceans separate each other.  Once again, I do thank you most sincerely…

L

Thank you for being such an excellent and conscientious surgeon. Also, I appreciated your phone call and reassurance last week very much.

M

Thank you for your care and kindness

F

It is quite difficult to thank someone who has literally saved your life! My gratitude is difficult to express. Thank you for your dedication to your work and compassion with all those you deal with in my position. You are a treasure to our community and your work is truly humbling

A

There are only a few people in ones life that they will remember forever…and you are one of them

A

Thank you for all of your support and kindness.

J

Thank you for your care and for the trust you gave me.  Your support and thoughtfulness will always be remembered.

J

I know I’ve said it before, but it needs to be said again…thank you!  Your skill, dedication and care have been very much appreciated.  (Any my very neat scar is the focus of conversation with anyone who sets eyes upon it!) In sincere appreciation for all you have done”

S

I just wanted to say a big thank you for spending so much time talking with me at my appointment… I really appreciate your understanding words and empathy for how I am feeling at present.  Also, thank you for your encouragement and reassurance that things will get better and especially for working towards giving me another 50 years.

C

Thank you for taking such good care of me

S

Thank you for helping me through a rough patch.  I’m very lucky I was in such good hands.  You made being a doctor patient very easy.

T

Thank you for giving us the best Christmas we will ever have. How fortunate we are to have you as our Surgeon.

J

Thanks for looking after me, your TLC and your great support

J

Thank you so much for everything. You are a true professional and amazing at explaining medical terms and procedures. From the first time I stepped into our office at Kenmore, I felt comfortable and confident. I don’t think I can adequately express my happiness with you during this whole ordeal. You have set the GOLD standard to which I will be measuring every medical professional & encounter from here on. THANK YOU!

G

Thanks so much for being the person who was so instrumental in being responsible for my body being put on the road to complete recovery…Please accept my deepest gratitude for your skill and training and for your team’ support

R

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