Name of the Procedure:

Excision of Breast Lesion Identified by Preoperative Placement of Radiological Marker, Open; Single Lesion

Summary

In this procedure, a surgeon removes an abnormal area within the breast identified by a radiological marker placed before surgery. This marker ensures that the correct tissue is excised. The surgery helps diagnose or treat potentially cancerous lesions.

Purpose

The procedure is performed to remove and analyze suspicious or abnormal breast tissue. The goals are to diagnose or rule out breast cancer, alleviate symptoms, and prevent potential progression of the disease.

Indications

• Suspicious mammogram or ultrasound findings
• Presence of a palpable lump or lesion in the breast
• Previous biopsy results indicating the need for further tissue examination
• Symptoms like persistent pain or nipple discharge

Preparation

• Fasting may be required for up to 6-12 hours before the procedure.
• Patients may need to stop certain medications (e.g., blood thinners) as advised by their healthcare provider.
• Preoperative imaging tests (mammogram, ultrasound) to place the radiological marker.
• Blood tests and physical exam may be required to ensure fitness for surgery.

Procedure Description

1. The patient is positioned on the surgical table and given anesthesia (local or general).
2. A small incision is made in the breast.
3. Guided by the radiological marker, the surgeon excises the lesion and a margin of surrounding tissue to ensure complete removal.
4. The removed tissue is sent to a pathology lab for examination.
5. The incision is closed with sutures and covered with a sterile dressing.

Duration

The procedure typically takes 30 minutes to 1 hour.

Setting

The procedure is usually performed in a hospital operating room or an outpatient surgical center.

Personnel

• Surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurses
• Radiologist (for marker placement)

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma
• Scarring or changes in breast appearance
• Pain or discomfort
• Rarely, incomplete removal of the lesion, requiring additional surgery

Benefits

• Accurate diagnosis of breast abnormalities
• Potential removal of cancerous tissue, reducing the risk of cancer spread
• Relief from symptoms if the lesion was causing pain or discomfort
• Peace of mind with definitive pathological analysis

Recovery

• Immediate post-procedure care includes monitoring and pain management.
• Most patients can go home the same day.
• Recovery time is typically 1-2 weeks, with some activity restrictions.
• Follow-up appointments to check healing and discuss pathology results.

Alternatives

• Watchful waiting with regular imaging follow-up
• Core needle biopsy (less invasive)
• Fine-needle aspiration (for cystic lesions)
• Each alternative varies in invasiveness, diagnostic accuracy, and potential for complete lesion removal.

Patient Experience

• During the procedure, patients may not feel anything if under general anesthesia, or mild discomfort if under local anesthesia.
• Postoperative pain can be managed with prescribed pain medications.
• Patients may experience temporary swelling, bruising, and tenderness at the incision site.
• Supportive measures include wearing a comfortable, supportive bra and avoiding strenuous activities.

By following these steps, the surgeon aims to accurately diagnose and appropriately manage any suspicious breast lesions, with a focus on patient safety and effective outcomes.