Breast lumpectomy
Anesthesia type GA vs. MAC
Airway LMA for GA
Lines and access PIV
Monitors Standard
Primary anesthetic considerations
Preoperative
Intraoperative
Postoperative

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

Labs and studies

Operating room setup

Patient preparation and premedication

Regional and neuraxial techniques

Intraoperative management

Monitoring and access

  • PIV x 1
  • Place BP cuff office the surgical field
  • Make sure EKG leads are not near the sterile field

Induction and airway management

Positioning

  • Supine
  • Arms out

Maintenance and surgical considerations

Emergence

Postoperative management

Disposition

Pain management

Potential complications

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

References