Breast lumpectomy

Breast lumpectomy

Anesthesia type	MAC or General
Airway	LMA/ETT if GA
Lines and access	PIV
Monitors	Standard
Primary anesthetic considerations
Preoperative
Intraoperative
Postoperative	PONV
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A breast 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 is performed with wire localization, where a radiologist inserts the tip of a wire into the target tissue under fluoroscopic guidance preoperatively. This enables the surgeon to more precisely localize the lesion, and is more commonly performed for deeper lesions.

Preoperative management

Patient evaluation

System	Considerations
Neurologic
Cardiovascular
Pulmonary
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

Maintenance and surgical considerations

• Consider TIVA or partial TIVA, due to higher risk of PONV (patient population tends to be older females, who are at higher risk of PONV) and faster emergence.

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