Breast lumpectomy

Breast lumpectomy

Anesthesia type	GA vs. MAC
Airway	LMA for GA
Lines and access	PIV
Monitors	Standard
Primary anesthetic considerations
Preoperative
Intraoperative
Postoperative
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A lumpectomy is the removal of a discrete portion or “lump” of breast tissue. This procedure is sometimes referred to as a partial mastectomy.

Sometimes the procedure involves a wire localization step, where the patient has a wire inserted into the breast tissue under fluoroscopic guidance pre-operatively. The wire is placed by a radiologist such that the tip resides in the target tissue, thus enabling the surgeon to more precisely localize the lesion. Wire localization is more often done if the lesion is deeper.

Preoperative management

Patient evaluation

System	Considerations
Neurologic
Cardiovascular
Respiratory
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Intraoperative management

Monitoring and access

• PIV x 1

• Place BP cuff off the surgical field
• Make sure EKG leads are not near the sterile field

Positioning

• Supine
• Arms out

Procedure variants

	Superficial	Deep
Unique considerations	More likely MAC	More likely GA
Position
Surgical time	15-45 mins	30-60 mins
EBL	5-10cc	5-10cc
Postoperative disposition
Pain management
Potential complications