Refusing Axillary Dissection: what is proper legal paperwork?

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SccS
SccS Member Posts: 78
edited June 2014 in Lymphedema

I've posted this to "Surgery - Before, During, and After" topic, but maybe I should have also posted it here since this topic members may have a different view... This is original post:  http://community.breastcancer.org/forum/91/topic/791274?page=1#idx_4 .

My wife will be undergoing mastectomy soon. We know lymph nodes are involved but we're in huge fear of lymphedema, so she doesn't want all nodes removed. Neoadjuvant chemo is being done now. Surgeon very reluctantly agreed to remove layer 1 only, and partially layer 2, if he finds the latter suspicious, and leave layer 3 untouched. From reading these and other forums we see that often surgeons violate their promise and/or consent forms and remove all nodes. How do we make sure this won't happen? Is pre-surgical consent form enough? Any forms SURGEON should sign in addition to PATIENT signing some? There must be some proper legal procedure for that.

Any advice, please?

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  • kira66715
    kira66715 Member Posts: 4,681
    edited July 2012

    SccS,  I would think your wife should clearly write down her desires in the consent form for the surgery. The levels of lymph nodes are designated by their anatomical position, and I think it's pretty rare to go up to a level 3 removal.

    I think the best thing to do is to discuss with the surgeon, and write in the consent form that level one and two nodes only.

    Just my opinion. I hope all goes well for your wife.

    Kira

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  • SccS
    SccS Member Posts: 78
    edited July 2012
    Thank you.
    Do you think it's possible to know how many lymph nodes there are in level 2 ? We're thinking about stating something like: "agree to removal of not more that 50% of nodes in level 2"... Is it possible to know how many nodes there are prior to starting cutting them? Or, should she say "agree to removal of not more than 3 nodes of level 2"?
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  • exbrnxgrl
    exbrnxgrl Member Posts: 12,424
    edited July 2012

    Hi,

    As I mentioned earlier, it's my understanding, that the nodes are encased in a fatty wrapper of sorts. Until they are unwrapped it isn't known how many there are. I don't think they can be unwrapped and divided before removal. If I'm wrong, I hope someone will jump in and correct me.

    Caryn

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