Approach

• We care for patients with non-cancerous breast disease and breast cancer
• Our subspecialty surgeons work in a multidisciplinary fashion with medical oncologists, surgical oncologists, radiation oncologists, plastic and reconstructive surgeons, social workers, geneticists, pathologists, radiologists, patient navigators, psychologists and specialists in lymphedema.
• Our surgical team offers a variety of surgical approaches to breast cancer patients, personalizing treatment for each individual patient
• In addition to surgery, breast cancer treatment can include radiation therapy and systemic therapy
• The ultimate goal for each patient is to come up with a personalized plan that considers both the optimal cancer care and the expectations and desires of each patient.
•  

List of services 

Non-cancerous breast disease

• intraductal papilloma, fibroadenoma, lobular carcinoma in situ (LCIS), atypical ductal hyperplasia, nipple discharge, breast cysts, breast pain

Breast cancer

• Stage 0 – non-invasive breast cancer, called ductal carcinoma in situ DCIS. The cancer cells are confined to the milk duct and are not invading the surrounding tissue
  • Stage 1 – very early invasive breast cancer. Less than 20 mm (the size of a grape) and/or small clusters of cells in the lymph nodes
  • Stage 2 – in a limited region of the breast but has grown larger. Lymph nodes can also be involved.
  • Stage 3 – the tumor is larger in size than the earlier stages and can have more spread into the nodes
  • Stage 4 – the most advanced stage, the cancer has spread to distant parts of the body outside of the breast.

Breast Cancer Surgery

• Lumpectomy (breast-conserving surgery): removing only the cancerous tissue with a surrounding rim of normal tissue.
  • This is a same-day outpatient procedure
  • This operation requires postoperative radiation therapy.
• Mastectomy: the removal of all breast tissue
  • This is needed if the cancer takes up a large portion of the breast, or is in multiple locations in the breast
  • Mastectomy can be done with or without reconstruction
  • We offer a plastic surgery consult for all mastectomy patients
    • Simple mastectomy: removal of the entire breast including skin, nipple and areola
    • Modified radical mastectomy: the removal of all breast tissue and the underarm lymph nodes that have been affected by cancer.
    • Skin-sparing mastectomy: the removal of all breast tissue with preservation of the skin of the breast, but not the nipple and areola.
    • Nipple-sparing mastectomy: the removal of all breast tissue preserving the skin of the breast, the nipple, and areola. This operation is offered in select cases.

Axillary Lymph Nodes

• Sentinel lymph node biopsy: When performing lumpectomy or mastectomy for invasive cancer, a lymph node biopsy will be done to see if cancer has spread. Sentinel lymph nodes are the first nodes that the cancer cells would travel to if there were to leave the breast.
• Axillary lymph node dissection: The removal of the axillary lymph nodes when cancer has spread to those lymph nodes.

Reconstructive Surgery

• Oncoplastic surgery: The objective of oncoplastic surgery is to combine complete tumor resection with optimal cosmetic outcome in the setting of breast conserving surgery (lumpectomy).
• Oncoplastic surgery is considered an integral part of “personalized surgery” and underscores the need to tailor surgery to each individual patient and breast cancer.

Post-mastectomy breast reconstruction:

• Autologous tissue reconstruction: This technique uses muscle and fat derived from the patients’ body (usually from the back or the stomach) to re-create the shape of the breast.
• Implant based reconstruction