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Laura M.
Picc and the mastectomy patient

Can I get your comments on why you would not place a picc in a mastectomy patient or why it is okay to?  I did a search on this website and didn't find anything.  It's my understanding we don't place picc's in this population due to the lymph nodes being removed and sets the patient up for complications with cellulitis, infection, etc...  Does INS have a standard for this?  Any comments are appreciated. Thank you.

The national standard from

The national standard from INS and ONS is that the extremity on the side of a mastectomy should never be used for venipuncture of any kind due to the increased risk of lymphedema. This is a life-long risk. The risk is not as great when the lymph nodes have not been removed, however venipuncture in that arm should always be avoided. In the case of bilateral mastectomy, you must make a careful assessment for each patient about what type of vascular access device would create the least risk for that patient. Lynn 


Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

 For bilateral mastectomy
 For bilateral mastectomy Pt’s we place their picc via the EJ route.  We’ve used this practice for > 12 years W/ great success & no complications R/T lymphedema.  Occasionally W/ a single side mastectomy, we’ll use the opposite arm but this complicates things for BP’s & additional PIV’s if later needed.  If they’re in the ICU W/ multi meds & possibly monitoring, we place a TL via EJ & keep the unaffected arm free for other use.


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