c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Needle Localization Breast Biopsy: 4

A D V E R T I S E M E N T

   
 

The incision is oriented so that it can be easily excised with the specimen without compromising the skin flaps if a mastectomy is performed later. A mixture of 1% lidocaine, 1/4% marcaine and bicarbonate without epinephrine (surgeon's choice) is infiltrated to raise a wheal. The stretching of the skin induces immediate anesthesia even before the drug effect. A cone shaped deep inflitration through the wheal prepares for the first stage of dissection. Supplemental sedation is used.     

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Needle Localization Breast Biopsy: 5

A D V E R T I S E M E N T

   
 

The skin is incised and separated from the needle shaft. Small skin flaps are raised beneath the level of the subdermal plexus. The breast tissue around the needle is grasped firmly with Adson forceps, and a deep figure-of-eight suture of 2-0 silk on a large cutting needle is placed through the tissue and around the needle shaft. This firmly fixes the tissue to the needle and provides traction without using obtrusive grasping clamps like the Alis.      

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Needle Localization Breast Biopsy: 6

A D V E R T I S E M E N T

   
 

Using the silk and an attached hemostat for traction, additional local is infiltrated in preparation for the next stage of dissection, to allow it time to work. The infiltration follows the perimeter of the planned excision.       

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This page was last modified on 1/20/2000.