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| considerations_intraoperative =  
| considerations_intraoperative =  
| considerations_postoperative = Urine, emesis or stool may be blue for 24-48h if dye is injected
| considerations_postoperative = Urine, emesis or stool may be blue for 24-48h if dye is injected
}}A '''breast biopsy''' is the surgical removal of breast tissue for histopathological analysis, usually in the setting of suspicious findings discovered on mammography or ultrasonography. This procedure can take many forms, including fine-needle aspiration cytology (FNA), core needle biopsy, open breast biopsy, excisional biopsy, and lumpectomy, and may be associated with sentinel lymph node biopsy. <ref>{{Cite book|url=https://www.worldcat.org/oclc/888551588|title=Anesthesiologist's manual of surgical procedures|date=2014|others=Richard A. Jaffe, Clifford A. Schmiesing, Brenda Golianu|isbn=978-1-4963-0594-7|edition=Fifth edition|location=Philadelphia|oclc=888551588}}</ref>   
}}A '''breast biopsy''' is the surgical removal of breast tissue for histopathological analysis, usually in the setting of suspicious findings discovered on mammography or ultrasonography. This procedure can take many forms, including fine-needle aspiration cytology (FNA), core needle biopsy, open breast biopsy, excisional biopsy, and lumpectomy, and may be associated with sentinel lymph node biopsy.<ref>{{Cite book|url=https://www.worldcat.org/oclc/888551588|title=Anesthesiologist's manual of surgical procedures|date=2014|others=Richard A. Jaffe, Clifford A. Schmiesing, Brenda Golianu|isbn=978-1-4963-0594-7|edition=5th|location=Philadelphia|oclc=888551588|last=|first=|publisher=|year=|pages=}}</ref>   


== Preoperative management ==
== Preoperative management ==

Revision as of 02:52, 9 July 2021

Breast biopsy
Anesthesia type

Depends on size of lesion, depth of lesion, and amount of tissue to be sampled. Includes local, local with IV sedation, or GA.

Airway

Natural airway, LMA or ETT

Lines and access

PIV 18-20G x 1 if sedation is to be used

Monitors

Standard monitors

Primary anesthetic considerations
Preoperative

Patients with previous history of breast cancer may have had prior lymph node involvement and one arm may be unavailable for lines

Intraoperative
Postoperative

Urine, emesis or stool may be blue for 24-48h if dye is injected

Article quality
Editor rating
In development
User likes
0

A breast biopsy is the surgical removal of breast tissue for histopathological analysis, usually in the setting of suspicious findings discovered on mammography or ultrasonography. This procedure can take many forms, including fine-needle aspiration cytology (FNA), core needle biopsy, open breast biopsy, excisional biopsy, and lumpectomy, and may be associated with sentinel lymph node biopsy.[1]

Preoperative management

Patient evaluation

System Considerations
Neurologic
Cardiovascular
Respiratory
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Labs and studies

  • Only as indicated from H&P

Patient preparation and premedication

  • Can be a high-anxiety procedure, consider midazolam
  • Consider scopolamine patch in young women at high risk for PONV

Intraoperative management

Monitoring and access

  • Standard ASA monitors
  • 18-20G PIV x 1

Induction and airway management

  • Natural airway for procedures that can be done under local +/- sedation including FNA, core needle biospy
  • LMA vs. ETT for deeper lesions, resections, and sentinel node biopsies

Positioning

  • Supine with ipsilateral arm abducted
  • Table may be airplaned to center breast

Maintenance and surgical considerations

  • Standard maintenance, muscle relaxants often not required

Emergence

  • No special considerations

Postoperative management

Disposition

  • PACU > home

Pain management

  • Pain score 2-5
  • PO analgesics

Potential complications

  • Hematoma formation
  • Infection
  • Seeding of tumor to other sites

Procedure variants

FNA/Core Needle Biopsy Open Breast Biopsy Lumpectomy/Excisional Biospy
Unique considerations
Position
Surgical time
EBL
Postoperative disposition
Pain management
Potential complications

References

  1. Anesthesiologist's manual of surgical procedures. Richard A. Jaffe, Clifford A. Schmiesing, Brenda Golianu (5th ed.). Philadelphia. 2014. ISBN 978-1-4963-0594-7. OCLC 888551588.CS1 maint: others (link)