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PICC Placement & Mastectomy
I was wondering if anyone out there knows of an evidence based practice article related to why PICC placement is contraindicated with mastectomy.  I talked with a physician the other day who was requesting PICC placement in a patient who had bilat mastectomies, and he thought it was "old school" to not place a PICC just because the pt had mastectomies.  I was taught to not even use a mastectomy affected extremity for bp's, not to mention PICC placement.  I would appreciate any feedback.
Robbin George
I will be interested to see

I will be interested to see the responses to this question as I too have had a Physician recently question the need for this particular contraindication

Robbin George RN VA-BC

There is very little

There is very little published about this, however, the ONS guidelines still contain warnings about using the ipsilateral side of a mastectomy for any venipuncture. The risk of lymphedema never goes away. Some surgical procedures that do not involve lymph node dissection creates a smaller risk of lymphedema, however the risk is still present. This is not "old school" but still very much a concern for patients especially with lymph node dissection. 

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

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

We have been seeing an
We have been seeing an increase in docs wanting us to place PICCs in mastectomy arms.  Two cases I remember in particular.  One pt. had bilat. mastectomy, lymph nodes intact, plastic surgeon and infectious disease both said okay (pt. needed antibiotics worse than going without them.)  The other more recently had bilat. mast., lymph nodes intact on the left and the docs said it was okay to use that arm.  But she had previous ports with scar tissue and it was like a brick wall once we got up so far.  She is now on our "Unable to Place" list.
Karen Day
Karen Day's picture
we too have actually placed

we too have actually placed piccs in mastectomy ipsilateral sides when lymph nodes have been left in tact.  Usually you will find this on more recent mastectomies, plus the fact that our surgeons have performed the procedure and we can communicate with them to verify that lymph nodes were indeed left intact.  If the patient doesn't know and we can't find any documentation about lymph nodes, we don't place the picc line due to the associated risks.


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