Partial Mastectomy with Wire Localization and Axillary Dissection adobe acrobat pdf of 'Partial Mastectomy with Wire Localization and Axillary Dissection'

You have been found to have a small tumor or cancer in the breast that has been recommended to be removed, but cannot be felt. In addition, there has been some spread to the lymph nodes that will have to be removed for complete evaluation. Since we cannot feel the area in the breast, a very thin wire will be placed to assist in locating the correct area. There will be two incisions, one in the breast and one in the axilla (arm pit) area.

Hereís what to expect:

Morning of surgery:
Please check-in at the place and time Patricia has asked on your registration sheet.

Once checked-in, you will be taken to a pre-op room and asked to change into a hospital gown and given scrub pants to wear. Your family can stay with you. We ask that you limit the number of family members as the rooms cannot accommodate a large crowd. Your family can keep your clothing or it can be placed in a locker for safe keeping. A nurse will check your vital signs and go over important medical history. You will be escorted to the Breast Center where a mammogram or ultrasound will be done. At that time, the Radiologist will insert the wire. Once completed, you will be escorted back to the Day Surgery area.

You will see me prior to the surgery and have an opportunity to ask any additional questions that you may have. A nurse or an anesthesiologist will start an IV. In some cases, a sedative will be given to relax you prior to going to the operating room. Once you have been taken to the operating room, your family is to go to the waiting room until your surgery is completed.

In the operating room:
Once in the operating room, you will be transferred to the operating table. In the room, there are key personnel including the circulating nurse, a scrub tech, anesthesiologist, and myself. Several monitors will be connected to watch your vital signs during the procedure. Once all that is complete, you will be given anesthesia to go to sleep. After the breast tissue is removed, it is sent for x-ray to confirm the correct area was removed. Then the lymph nodes will be removed. A drain will be placed in the axillary area to collect any fluid the body may make in the healing process. The average duration of this procedure is 1 hour to 1 Ĺ hours. Please allow additional time for transportation time and time to get the patient off to sleep. All tissue removed is sent to the lab for complete analysis.

After surgery:
Once your surgery has been completed, you will be taken to the recovery room and I will let your family know your surgery is done. You will spend approximately one hour in the recovery room, sometimes less, sometimes a bit more, depending on how you metabolize the medications given to you.

When you are awake, the nurse will help you get dressed and transfer you to the discharge area. At that time, your family will be called to come and sit with you. You may be given some juice, soda, or crackers or assisted to the rest room if necessary. Discharge instructions will be given to you as well as any prescription for pain medication that I may have written along with instructions on how to manage the drainage tube.

Once you go home:
Expect to be a bit groggy for a while. I ask that you do not drive a car or operate any machinery that day. You will have no other restrictions as far as your diet or activity.

Sometimes, the anesthesia can make you a bit nauseous. Donít be alarmed, that usually resolves by the next day. It may be helpful to apply an ice-pack to the breast to help alleviate any discomfort or swelling. If you donít have an ice-pack, you can make one by taking a wash cloth and wetting it. Fold it and put it in the freezer for a while. Once cold and ďcrunchyĒ place it in plastic wrap or a zip lock bag. Instant ice-pack. You can even prepare this the day before so itís ready when you get home. You may wear a bra if you would like to for comfort, but itís not necessary.

Most of my patients experience very little pain. You may take Tylenol, Advil, Aleve, or any other over the counter pain medication if you like. The prescription you will get is for a narcotic and is stronger just in case you need it. If you do not have pain, you do not need to take any prescription medication. Very often, the axillary incision is more bothersome than the breast.

The day after surgery, you may remove the bandage from the breast and axilla. Leave the dressing over the drainage tube. Under the bandage you will see small white tapes, steri-strips. Leave those alone. I DO NOT want you to take a shower until the drainage tube is removed. That is usually about 7-10 days average. Sponge bath only. You can wash under the arm if you want and even use deodorant. Your incision cannot open up accidentally. All stitches are under the skin and will dissolve.

Please do not remove any dressings around the drain and follow the instructions given to you about emptying and recording the drain output. Be sure to bring the record of drainage to your follow-up visit.

I will want to see you in the office after surgery to see how you are healing and to go over the pathology results. Depending on that, your next follow-up visit will be determined.

Thank you for allowing me to participate in your care. It means a great deal to me and my staff that you would trust us with such an important matter.

Should you have any questions, please do not hesitate to contact the office or staff.

Thank you,
Dr. Arlene Ricardo
 
Dr. Arlene E. Ricardo, M.D.