One out of 8 women will develop breast cancer in her lifetime, and breast cancer is the second most common cause of cancer death in women. The high risk factors of developing breast cancer include being a woman between the ages of 35 – 65 and having a blood relative (mother, grandmother, or sister) that has had breast cancer.
Many lives can be saved through the early detection of breast cancer in a stage that is 90 – 95% curable. In many cases, this cure rate can be achieved by the modern technique of conservative treatment which saves the breast and does not require mastectomy.
Breast Cancer Warning Signs
The warning signs of breast cancer include a lump or thickening of the breast tissue, dimpling of the skin on the breast, a bloody discharge, and/or an abnormal mammogram. Monthly self-breast exams and a yearly physical are of the utmost importance in diagnosing breast cancer. Along with these methods a mammogram, which is a low-dose X-ray of the breast, is a vital part of finding early curable breast cancer. Mammography can often detect a small, early breast cancer several years before you or your doctor may feel it. Since it is found very early, the chances for a successful cure are significantly increased.
Mammogram Guidelines
The American Cancer Society provides the following age guidelines for scheduling a mammogram:
- 35 - 39: Baseline mammogram.
- 40 – 49: Mammogram every one to two years.
- 50 and over: Mammogram every year.
Our Surgeons specialize in the comprehensive treatment of breast cancer from biopsies to the surgical removal of the cancer, utilizing the latest available technological options.
We will discuss all options and treatments with you in detail, so that you can make an informed decision. Our goal is to select a treatment option that you are comfortable with and one that will yield the most successful treatment results.
CORE NEEDLE AND STEREOTACTIC BREAST BIOPSY
This procedure assists physicians in obtaining the right amount of breast tissue for a definitive diagnosis without surgery. The Mammotome Breast Biopsy can detect tiny abnormalities which can be the earliest or only signs of cancer, making early detection and an accurate diagnosis easier. Stereotactic (X-rays from two angles) or ultrasound (sound waves) images guide the Mammotome probe into the abnormal area where multiple tissue samples are removed. This type biopsy causes little pain, requires no sutures, and can be performed quickly.
OPEN SURGICAL BREAST BIOPSY
Generally, an open surgical breast biopsy is done using local anesthesia as one day surgery. The incision to remove the lump is usually small and cosmetically performed. The lump is then examined under a microscope to determine if it is benign or malignant. The surgery takes 30 minutes to one hour, and you may go home immediately following the biopsy. You will be able to return to normal activities almost immediately after surgery but will need to limit lifting with your arm on the side of the biopsy. Final results of your biopsy will be known in 2 – 3 days.
BREAST CANCER SURGERY
Our approach to cancer of the breast allows breast-conserving surgery for most breast cancers. This approach involves the cooperation of medical oncologists, radiation oncologists and surgeons.
Sentinel Node Lymph Biopsy
Sentinel Node Lymphatic Mapping and Biopsy is a new procedure used in some cancers (particularly with breast and melanoma) to determine if the cancer has spread to the lymph nodes. The procedure involves injecting a radioactive marker and blue dye into the area of the tumor. The dye is absorbed into the lymphatic system and identifies the "sentinel node", or the node that is closest to the tumor. The surgeon is able to accurately identify and remove the sentinel node and send it to the pathologist for precise diagnosis. The theory applies that patients with no cancer in their lymph nodes do not need further radical resection, while those patients with positive lymph nodes (cancer cells are detected) do need lymphadenectomy (removal of lymph nodes) of the involved area.
Lumpectomy
In a lumpectomy, the breast mass is removed with a rim of healthy tissue all around it. Women are usually concerned that such an excision will lead to dimpling, or a reduction in the size of the breast. In reality, most lumpectomies result in a very acceptable cosmetic result with very negligible loss of breast volume. Radiation therapy is usually undertaken after the surgery in order to achieve recurrence rates that are comparable to those that used to be achieved after a mastectomy. As stated above, most, but not all, women with breast cancer are candidates for this surgery in combination with radiation therapy.
Mastectomy
Occasionally, a mastectomy is recommended to remove the cancer. There are three types of mastectomy. In a total mastectomy, the surgeon removes the entire breast and usually some lymph nodes from under the arm. This is also called a simple mastectomy. In a modified radical mastectomy , the surgeon removes the breast, most of the lower and middle lymph nodes and the lining over the chest muscles. Part of the chest wall muscles may be removed as well. A radical mastectomy involves removing the breast, chest muscles and most of the lower, middle and upper lymph nodes. Years ago, this surgery was done often; it is rarely performed today.
Skin-Sparing Mastectomy in Conjunction with Reconstruction
With many mastectomies, a skin-sparing mastectomy can be carried out. The surgeon and a plastic surgeon work together to complete both procedures at the same time. This allows removal of the cancerous and necessary surrounding tissue as well as a reconstructive procedure to begin restoration of necessary volume to the breast. This may be followed at a later date by further plastic surgery to restore more volume and shape.
Hospitalization after some breast surgery usually requires 1-2 days, and pain medication will control minimal discomfort. After surgery, you will be followed regularly for many years to identify any recurrence of the breast cancer, so that further treatment can be immediately initiated.
