29 doctors weighed in:

Is a lumpectomy for breast cancer done with a local or general anesthesia?

29 doctors weighed in
Dr. Regina Hampton
Breast Surgery
17 doctors agree

In brief: Anesthsia

In my practice, I use a heavy sedation (also known as mac) with local or general anesthesia.
It depends on how extensive the mass and if i need to do a procedure on the lymph nodes. With proper pre operative physical exam, the risk for anesthesia can be assessed and the appropriate method can be selected. It is important to be comfortable so the surgeon can complete the procedure safely.

In brief: Anesthsia

In my practice, I use a heavy sedation (also known as mac) with local or general anesthesia.
It depends on how extensive the mass and if i need to do a procedure on the lymph nodes. With proper pre operative physical exam, the risk for anesthesia can be assessed and the appropriate method can be selected. It is important to be comfortable so the surgeon can complete the procedure safely.
Dr. Regina Hampton
Dr. Regina Hampton
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1 comment
Dr. Karen Sibert
Spinal anesthesia isn't a good technique for breast surgery. COPD/asthma is a problem, but not a contraindication to general anesthesia. See your anesthesiologist in advance of surgery to get information about all the options for anesthesia. You wouldn't necessarily need a respirator, although that might be the safest choice during surgery and could be stopped afterward.
Dr. Sean Canale
Breast Surgery
9 doctors agree

In brief: Depends on pt

Lumpectomy alone is fine under local with sedation added.
Pts usually fall asleep but don't need to be "put" to sleep with breathing tube & paralysis. When sentinel node bx is added, we usually opt for general (intubated or laryngeal mask if anesth will do it) since it's longer and the axilla & behind the muscle is harder to access & numb. Regional block is feasible but rarely offered by anesth.

In brief: Depends on pt

Lumpectomy alone is fine under local with sedation added.
Pts usually fall asleep but don't need to be "put" to sleep with breathing tube & paralysis. When sentinel node bx is added, we usually opt for general (intubated or laryngeal mask if anesth will do it) since it's longer and the axilla & behind the muscle is harder to access & numb. Regional block is feasible but rarely offered by anesth.
Dr. Sean Canale
Dr. Sean Canale
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1 comment
Dr. Karen Sibert
A laryngeal mask (LMA) isn't appropriate for all patients, especially if they are obese or have reflux. Regional blocks (paravertebral) for breast surgery have an extra risk of collapsed lung.
Dr. Karen Sibert
Anesthesiology
5 doctors agree

In brief: Either or both

Most often, the surgeon will inject some local anesthesia and the anesthesiologist will give some sedation as well.
Sometimes general anesthesia is needed due to the specific health problems of the patient, or the location of the tumor. A tumor deep within a breast requires more anesthesia than one that is close to the skin. Talk to the anesthesiologist and surgeon about the options.

In brief: Either or both

Most often, the surgeon will inject some local anesthesia and the anesthesiologist will give some sedation as well.
Sometimes general anesthesia is needed due to the specific health problems of the patient, or the location of the tumor. A tumor deep within a breast requires more anesthesia than one that is close to the skin. Talk to the anesthesiologist and surgeon about the options.
Dr. Karen Sibert
Dr. Karen Sibert
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Dr. Barry Rosen
Surgery
5 doctors agree

In brief: Twilight

I perform lumpectomies under local anesthesia supplemented by IV sedation ("twilight" anesthesia).
When performing lumpectomies for breast cancer, i usually will perform a sentinel lymph node biopsy at the same time. Depending on the patient, this is commonly performed under twilight or general anesthesia. Regardless, this is out-patient surgery with a very short recovery time.

In brief: Twilight

I perform lumpectomies under local anesthesia supplemented by IV sedation ("twilight" anesthesia).
When performing lumpectomies for breast cancer, i usually will perform a sentinel lymph node biopsy at the same time. Depending on the patient, this is commonly performed under twilight or general anesthesia. Regardless, this is out-patient surgery with a very short recovery time.
Dr. Barry Rosen
Dr. Barry Rosen
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2 comments
Dr. Barry Rosen
Local anesthesia is like what you get from a dentist when you have a filling --an injection to numb you but you are wide-awake. Twilight (or IV sedation) adds meds to sedate you. During General Anesthesia you are unconscious. Despite your asthma/COPD, you still may do well with General--discuss with your lung specialist and surgeon ASAP.
Dr. Karen Sibert
Local anesthetics numb the area. General anesthesia puts you completely to sleep, whereas sedation usually helps you relax or nap while local anesthesia provides adequate pain relief. Talk to your anesthesiologist and surgeon about the safest options for your surgery, considering any underlying health problems you may have.
Dr. Richard Pollard
Anesthesiology
3 doctors agree

In brief: Usually sedation

This is usually done under local anesthesia with IV sedation.
If there is going to be a lymph node dissection as well then the anesthetic may be increased to a general.

In brief: Usually sedation

This is usually done under local anesthesia with IV sedation.
If there is going to be a lymph node dissection as well then the anesthetic may be increased to a general.
Dr. Richard Pollard
Dr. Richard Pollard
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