My doctors diagnosed me with Breast Tumor as a result of the examinations and tests performed on me suggested ………………………………………….mastectomy (removal of the breast) surgery. During this operation, it was said that all or a part of the diseased breast and lymph nodes under the armpit on the same side would be removed. This surgery will be performed by the ………………………… team and the estimation of the procedure. It was told to me it would take ………………………. hours/minutes.
The following risks and possible dangers related to this surgery were explained to me:
1. As with any surgery, complications of anesthesia (unexpected situation) may occur. The type of anesthesia to be applied in the surgery and its complications will be explained by the anesthesia clinic team.
2. The shape and size of the surgical incision is appropriately determined by the surgical team.
3. Antibiotics can be administered against possible infections, but it is medically impossible for this practice to reduce the risk of infection to zero. These infections can develop in the wound, lungs and respiratory tract, urinary tract. In some cases, they may require reoperation or various surgical interventions. Despite intervention and antibiotic treatment, there is a risk that the infection will spread and cause death.
4. Clots that may form in the deep vein system during and after surgery may break off from there and cause vascular occlusion in various organs, especially in the lungs. In order to prevent this situation, measures will be taken according to the risk group. However, a method that will eliminate this risk 100% is not yet known in medicine. This is a very serious condition and there is a risk of death.
5. There may be internal or external bleeding during or after the operation. Accordingly, the patient may need to be given blood and blood products. This increases the risk of blood-borne diseases such as hepatitis and AIDS. Transplantation of blood and blood products has its own risks of complications and death.
6. In the postoperative period due to bleeding, the patient was re-operated for bleeding control may need to be done.
7. Organ injuries such as regional main vessel, nerve injury, and opening of the pleura may be in the surgery, and additional interventions may be required. Depending on these injuries, temporary or permanent disorders may develop in the arm, shoulder and regional skin. Unexpected conditions such as allergy, skin necrosis (decay), skin discoloration may develop depending on the sampling technique (dye and/or radioactive substance) in patients whose axillary lymph nodes are sampled. In these cases, additional intervention may be required.
8. Post-operative skin necrosis (decay), prolonged lymphatic fluid from the armpit, accumulation of blood or lymph fluid under the skin, prominent or irregular scarring, edema (lymphedema), pain in the arm, Movement limitation and/or loss of sensation may develop in the arm and shoulder. In these cases, additional intervention may be required.
9. If there is a malignant tumor, distant organ splashes that may be present during the surgery and that are too small to be detected by the diagnostic methods used by medical science today, may grow over time and cause the death of the patient. Tumor fragments that are too small to be detected visually or manually at the site where the tumor is removed during the operation may grow even long after the operation, causing regional recurrence of the disease and death of the patient.
10. After the examination of the excised tumor in the pathology laboratory, it can be decided that it would be beneficial to apply some additional treatments such as hormone therapy, radiotherapy and chemotherapy, as it may reduce the probability of regional recurrence and distant spread of the tumor. If the patient accepts the application of these additional treatments, the possible complications and risks related to these treatments are the responsibility of the practitioner radiation oncology and medical oncology teams, and extensive information about them will be given by the relevant branch physicians before the treatment.
11. After therapeutic surgery and additional treatments, if deemed medically appropriate at the request of the patient, breast implant, creation of a new breast with the patient’s own tissue or a combination of both (breast Reconstruction) may be possible. However, unexpected situations may occur during and after the operation.
12. In case of additional disease or drug use, necessary measures are taken to ensure the safety of surgery. However, unexpected situations may occur during and after the operation.
If I am pregnant, I have been informed that my unborn child carries a risk during examination/medical intervention/treatment/surgery and anesthesia procedures, primarily radiological procedures. I do not have a missed period or pregnancy.
PATIENT’S CONSENT
I was given the above detailed information about my disease and the planned intervention, and the possible complications and risks were fully explained. I was informed that if these develop, treatments, including surgery, may be required, but in some cases, complete cure or recovery cannot be achieved. I accept the implementation of the above-mentioned intervention and other additional interventions that may be required as a medical necessity during the intervention.
to this section;
The statement “I READ, I UNDERSTOOD, I GOT A COPY” written in the patient’s or Legal Representative’s own handwriting will be written..……………………………………………………………………………………..……………………
TO BE FILLED BY THE PATIENT:
Date of Consent:……………………………Time :………………………………………………
Signature:…………………………………………………………………………………………
Patient’s (guardian or guardian for restricted and minors) Name and surname:……………………………
TO BE FILLED BY THE DOCTOR INFORMING THE PATIENT AND TAKING THE PATIENT’S CONSENT:
Title, Name and Surname of the Physician Receiving Consent:…………………………………………………..
Signature:……………………………………………………………………………………………
TAKING MEDICAL INTERVENTION
Name Surname Title:……………………………………………………………………..
Signature:……………………………………………………………………………………