Breast Surgery Module 11

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Questions and Answers

What is the primary purpose of a sentinel node biopsy?

To perform a mastectomy

To predict the prognosis of patients with a breast lump (correct)

To provide immediate treatment for malignancy

To remove the tumor completely

Which type of anesthesia is most commonly used for an open breast biopsy?

General anesthetic for all patients

Local anesthetic exclusively

General anesthetic for comfort but can use local (correct)

Regional anesthetic only

What does a negative sentinel node biopsy indicate?

Adjunct therapy will follow immediately

The patient has a higher likelihood of survival (correct)

More immediate surgery is needed

The patient requires axillary node dissection

What is typically done during an open breast biopsy with wire localization?

A wire is placed into the breast lump to guide the surgeon Signup and view all the answers

What is typically the next step following a positive sentinel node biopsy?

Proceed with an axillary node dissection and adjunct therapy Signup and view all the answers

What consideration should be factored for patients undergoing a simple mastectomy?

The anxiety level of the patients Signup and view all the answers

What occurs after a sentinel node dissection with malignant results?

Staging of the disease with axillary node dissection is performed Signup and view all the answers

What is a key feature of open breast biopsy procedures?

They often can be performed with local anesthesia Signup and view all the answers

What is the role of the perioperative nurse regarding patient positioning?

They ensure that the patient is positioned safely before, during, and after surgery. Signup and view all the answers

What is the initial action required for breast surgeries regarding instruments?

Perform a minor count of all instruments. Signup and view all the answers

What should be done if cancer cells are detected in the breast biopsy?

Change surgical gloves and gowns and continue with a lumpectomy or mastectomy. Signup and view all the answers

Which action is NOT recommended when handling instruments used in a biopsy procedure?

Using the same instruments for both biopsy and subsequent larger procedure without changes. Signup and view all the answers

What procedural step must be taken if the pathology returns with negative results for cancer cells?

The wound is closed without further action. Signup and view all the answers

What must a nurse do with the sterile specimen container for a biopsy?

Send it to pathology without delay. Signup and view all the answers

Which of the following is a correct description of a fine needle aspiration biopsy?

It is an outpatient procedure used to rule out breast cysts or cancer cells. Signup and view all the answers

What is a common protocol for the minor instrument tray during breast procedures?

Commonly used instruments are placed on the mayo tray for easy access. Signup and view all the answers

Which arteries supply blood to the breast?

Internal Mammary Artery, Anterior Aortic Intercostal Arteries, Pectoral Branch of the Axillary Arteries Signup and view all the answers

What is the primary lymphatic drainage area for the breast?

Axillary nodes and internal thoracic nodes Signup and view all the answers

What is the most common form of breast cancer?

Infiltrating Ductal Carcinoma Signup and view all the answers

What is the recommended position for a patient undergoing breast surgery?

Supine position Signup and view all the answers

Why is specimen handling important in breast surgeries?

To accurately diagnose the type of carcinoma Signup and view all the answers

What role does patient anxiety play in the context of a breast cancer diagnosis?

It can lead to decreased communication between clinician and patient Signup and view all the answers

Which of the following nerves contribute to the nerve supply of the breast?

Anterior cutaneous branches of upper intercostal nerves Signup and view all the answers

What is a primary consideration in preoperative nursing care for breast surgery patients?

Providing sensitive and supportive care Signup and view all the answers

Study Notes

Breast Anatomy and Cancer Overview

Breast cancer primarily affects women, with less than 1% of cases in men.
Infiltrating Ductal Carcinoma is the most prevalent form of breast cancer.
Early detection significantly improves survival rates.

Blood Supply and Nerve Supply

Blood supply to the breast includes the Internal Mammary Artery, Anterior Aortic Intercostal Arteries, and Pectoral Branch of Axillary Arteries.
Lymphatic drainage follows blood vessels, primarily involving axillary and internal thoracic nodes.
Nerve supply consists of anterior cutaneous branches of upper intercostal nerves and branches of the cervical plexus.

Nursing Considerations

The emotional impact of a breast cancer diagnosis can be significant on patients and families.
Patient anxiety due to cancer diagnosis and body image changes necessitates sensitive care.
Patient positioning during surgery is typically supine; adherence to ORNAC Standards is essential for safety.

Instrumentation and Counting

A minor instrument tray is required for all breast surgeries, with initial and final counts conducted for accuracy.
Common instruments should be placed on a mayo tray for accessibility, ensuring contamination prevention.

Specimen Handling and Procedural Considerations

Maintain sterile setup until pathology results are confirmed; a new surgical gown/gloves may be necessary if cancer cells are detected.
Specimens are sent for pathology immediately in sterile containers.
Surgical instruments must remain separated to ensure clean technique post-biopsy.

Surgical Interventions

Various biopsy types include Fine Needle Aspiration, Core Needle Biopsy, and Open Breast Biopsy, each with varying anesthetic requirements.
Open Breast Biopsy can involve wire localization for targeted tissue removal.

Sentinel Node Biopsy

A sentinel node is the first lymph node impacted by a tumor and predicts prognosis.
Negativity in sentinel node biopsy indicates a higher survival likelihood; positivity requires further axillary node dissection.
A Geiger-counter device aids the surgeon in identifying the sentinel node during the procedure.

Mastectomy Procedures

Simple Mastectomy involves the removal of the entire breast, applicable for benign or localized malignant conditions.
Modified Radical Mastectomy coupled with Axillary Node Dissection helps stage cancer and is performed after malignant sentinel node results, preserving critical nerves.

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Description

Explore the essential concepts in Breast Surgery through Module 11. This quiz encompasses normal breast anatomy and instrument isolation techniques relevant to surgical procedures. It's designed for those studying or practicing in the field of surgical care.