Photograph of a large mammary tumor in a 13-year-old female dachshund.

LUMPECTOMY

GENERAL INFORMATION

• Prior to surgical lumpectomy consider skin tension lines, shape of excision, tissue type, and closure.
• The best opportunity for a surgical cure of neoplastic tumors is during the first surgery – keep margins wide!
• For benign tumors, 1cm margins will suffice. For malignant tumors, margins greater then 3cm may be necessary.
• Be wary of the “benign-looking tumor”, i.e., lipoma. It may actually be a malignant type, i.e., mast cell tumor.

 

MOST COMMON COMPLICATIONS AND DIFFICULTY

• Complications are rare. Delayed healing may occur if extensive resection is necessary.
• Failure to plan closure prior to surgery, resulting in inadequate hair clip.
• Failure to plan the excision shape and direction with the patient’s natural lines of skin tension, especially with movement, resulting in excessive tension on the closure.
• Failure to submit tissue for histopathological evaluation.

"EXPERTS' ADVICE"

• If it’s worth taking out – it’s worth submitting it for histopathology.
• Be sure to include wide margins in your resection. Think three dimensionally and be sure to remove tissue that may have neoplastic cells on all borders, including the deep border of the incision.
• Mark the borders so that if the histopathology report suggests that the borders are dirty, you know where to resect additional tissue.
• ALWAYS measure and draw the surgical margin prior to cutting.

 

Always attempt to get at least 1cm margins (preferably 2-3cm) around the mass, and always submit it for biopsy! Since there is often high tension on the wound, a suture with good, long term tensile strength may be warranted.


LUMPECTOMY:
SUTURE AND NEEDLE OPTIONS

	Brand		Needle Type	Needle Reference
	Main Choice	Also Possible		Main Choice	Also Possible
INTERNAL	MONOCRYL* VICRYL* PLUS		Taper Point	SH, CT-2, CT-1
SUBCUTANEOUS	MONOCRYL* VICRYL* PLUS	PDS* II VICRYL*	Taper Point	RB-1, SH, CT-2, CT-1
SKIN CLOSURE	ETHILON* PROLENE*	Silk	Reverse Cut	FS-2, FS-1, FS	FSL, CP-2, CP-1, KS

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	Cat/Small Dog (20 lbs or less)	Medium Dog (20-45 lbs or less)	Large Dogs (50 to 75 lbs)	Giant Dog (75 lbs +)
INTERNAL	4-0 or 3-0	3-0 or 2-0	3-0 or 2-0	2-0
SUBCUTANEOUS	4-0	4-0 or 3-0	3-0 or 2-0	2-0
SKIN CLOSURE	4-0	4-0 or 3-0 or 2-0	3-0 or 2-0	2-0

 

Use the suture selection tool for specific product code recommendations.