Depending on the diagnosis, surgery can be done as a stand-alone procedure or in conjunction with other prescribed therapies. Sylvester’s surgical oncologists are highly specialized in surgical options for breast cancer.
These types of procedures remove the cancerous tissue, but not the breast itself. Surgeries such as lumpectomies and partial mastectomies are examples of breast-conserving surgeries. Your doctor will discuss your options and help you decide what's right for you.
This procedure removes a tumor (lump) and a small amount of normal tissue around it. Sylvester cancer surgeons pioneered the technique for oncoplastic lumpectomy and now teach other surgeons around the country. During a lumpectomy, your surgeon removes the tumor and a small area of surrounding tissue. Your doctor sculpts the remaining breast tissue to give your breast a natural appearance, with touch-ups to the other breast to make them match.
Lumpectomy With Breast Reduction
For women with large breasts, the surgical oncologist and plastic surgeon can do breast-reduction surgery, starting with the cancerous breast to make sure the removed tissue contains the lump and a clean — or safe — margin around the lump. The plastic surgeon reduces the other breast to match.
This surgery, also called a segmental mastectomy, removes a larger part of the breast than a lumpectomy.
Skin and Nipple-Sparing Mastectomy
When appropriate and possible, this procedure preserves the skin and nipple to minimize scarring and improve your surgeon's ability to reconstruct your breasts.
A mastectomy removes the entire breast that's affected by cancer. The surgeon may remove one or more of the lymph nodes under your arm during surgery, or as a separate procedure later, to see if cancer has spread.
Sentinel Lymph Node Biopsy
Doctors use this minor surgery to determine if cancer has spread beyond a primary tumor into your lymphatic system. A sentinel lymph node is the first place cancer cells may move to when they begin to spread. During the biopsy, your doctor injects a special dye (tracer) to locate the nodes and remove them to look for cancer cells. If they're free of cancer, it means it's unlikely that cancer has spread and it's not necessary to remove more lymph nodes.
Sylvester offers a novel treatment that prevents taking more lymph nodes, even if the sentinel node is suspicious. Before surgery, an ultrasound scan of the armpit can highlight which lymph nodes are involved (they will appear enlarged or swollen). When chemotherapy is used before surgery (neoadjuvant chemotherapy), it can convert a previously positive lymph node to negative when biopsied, which means more lymph nodes don't need to be removed.
Venous Lymph Node Transfer and Lymphatic Grafting
If you have lymphedema from a previous surgery, Sylvester’s expert surgeons can prevent or provide relief from the debilitating condition caused when cancerous lymph nodes in the armpit must be removed during surgery, disrupting the normal flow of lymphatic fluid out of the arm. With nowhere to go, the fluid backs up in the tissues of the limb, causing painful swelling. In vascularized lymph node transfer, lymph nodes and their blood supply are transferred into regions where lymph nodes have been dissected to restore normal drainage.
Your radiation oncologist will discuss if radiation therapy is appropriate for your cancer and which type of radiation delivery best suits your case. Types include internal radiation therapy such as brachytherapy (radioactive “seeds” implanted in the tumor); partial breast radiation therapy (higher doses pinpointed for a shorter time to accelerate therapy); and targeted external-beam radiation therapy.
If your breast cancer cells have estrogen and progesterone receptors, the cancer may grow more quickly. Hormone therapy to block estrogen and progesterone may be effective at preventing cancer recurrence.