Breast biopsy
From WikiAnesthesia
Breast biopsy
| Anesthesia type |
Local MAC General |
|---|---|
| Airway |
Noninvasive O2 LMA ETT |
| Lines and access |
PIV |
| Monitors |
Standard |
| Primary anesthetic considerations | |
| Preoperative |
If prior surgery, may have limb alert |
| Intraoperative | |
| Postoperative |
PONV Urine, emesis or stool may be blue for 24-48h if dye is injected |
| Article quality | |
| Editor rating | |
| 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 | |
| Pulmonary | |
| 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
- ↑ 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)
Top contributors: Olivia Sutton and Chris Rishel