Breast

Wide Local Excision (Breast)

OPERATION: Wide Local Excision (WLE) of Breast Lesion
ANAESTHETIC: General / local anaesthesia
POSITION: Supine, arm on the operative side extended on an arm board.
VTE PROPHYLAXIS: TED stockings, intermittent pneumatic compression, warming blanket.

INDICATION:
Breast carcinoma [/ benign lesion requiring excision] at [location, quadrant]. [Core biopsy / cytology confirmed]. Lesion [palpable / wire-guided localisation performed for impalpable lesion]. Breast conservation planned — excision volume less than 20% of breast volume. [Oncoplastic techniques not required.] Contralateral breast normal on preoperative imaging.

PROCEDURE:
WHO Checklist performed. Correct side and site confirmed with patient and marked. Correct patient confirmed in anaesthetic room.

ACCESS:
Lesion marked on breast in the operating position. [Peri-areolar / circumareolar / radial / inframammary fold] incision placed to minimise scarring and within potential mastectomy skin boundary. Skin incised cleanly. Subcutaneous dissection to expose the breast tissue overlying the lesion.

EXCISION:
Lesion excised as a cylinder from the subcutaneous tissue down to pectoralis major fascia using sharp dissection / diathermy. At least 1 cm of normal breast tissue taken in all directions around the lesion. Specimen palpated to confirm the palpable abnormality has been removed. Specimen NOT incised. [Cavity walls re-resected for additional clearance margin.] [Wire-guided excision: wire confirmed within specimen on specimen X-ray.]