Breast Lumpectomy w/Sentinel Node bx.

I’m not sure how other surgeons do their breast cases, but I wanted to share how ours are done & how I prepare for my breast cases.

The RNs have to write down a lot of information when a specimen is handed off. Prior to the case I take my sticker sheet & write on the back of it so that I can just fill in the blanks while she is telling us the information we need & I’m able to double-check it & verify that it’s correct when the RN is taking the specimen.

Here’s what I write down:
Time (it was taken out) –
SN #1 –
Axillary Level –
Hot Spot –
Xvevo # –

I write this down for about 4 sentinel nodes, in case she does that many.
Then, she does the lumpectomy & may take 1-2 specimens, so on the back I’ll write down lumpectomy #1… lumpectomy #2, etc. & time each came out. She will also say something like, “Short stitch marks superior margin, long stitch marks lateral margin.” Somtimes she will also add a new margin… old margin, etc. It’s very important to repeat what the surgeon says so you know it’s correct & write it down. Say it out loud when the RN is asking for the specimen & is showing it to you to confirm.

I also take the other half of my needle counter & in each space write #1, #2, #3 & #4 so she can set the specimens in each. I check mark each after they’re handed off.

I have been told by my surgeons that they love that I do this! I scrubbed one of our techs out of a case recently & we were in the middle of getting a specimen & she had a card to write things down but never wrote anything down… I just like to be as prepared as possible & know that all the information is correct. & I know that they appreciate it!! I also am not the best at remembering things & it’s easier for me to write it down. Plus, it’s important to make sure that the specimens are properly labeled. In one case I came into the room to see if they needed help & it was the end of the surgery & the specimens had not been recorded/labeled properly by the RN & the surgeon was NOT happy.

I cannot be certain, but I’m guessing the surgeon said out loud what they wanted the specimens to be labeled & the scrub tech did not repeat it–or at least did not write it down–and did not double-check what the specimen was at hand off & when/if the RN repeated the label to them when getting the specimen–the scrub tech just agreed with what they said & handed it off. COMMUNICATION is KEY!! Know what the specimen is & double-check & confirm with your RN when you’re handing it off. Don’t just hand it to them & say yup, that’s it, and not know. I think the most our surgeon has taken is 8! That’s a lot of specimens to keep track of. I want my surgeons to know that they can trust me and they don’t have to worry about things getting messed up & I think I have proved that.