Breast Surgery
Our understanding of breast cancer and its management is constantly evolving. At Milford Regional’s Breast Center, the team of surgeons, medical oncologists and radiation oncologists from Dana-Farber/Brigham and Women’s Cancer Center in Milford discuss each cancer patient’s case and work together to create the best treatment plan.
When evaluating a new patient with breast cancer, the Breast Center team incorporates staging methods and molecular profile to ensure the most accurate diagnosis and treatment plan. Staging includes tumor size and status of the axillary lymph nodes. We incorporate the tumor’s molecular profile to better define that particular patient’s cancer. This profile involves measuring estrogen receptor, progesterone receptor, HER2 over expression, as well as cancer grade.
For most women with breast cancer some form of surgery is necessary. In many cases, the greatest benefit of cancer treatment comes in the form of surgical removal of that cancer. It is important to know that most of our patients are treated with a lumpectomy and not a mastectomy. Our current breast preservation rate is in the range of 75-80 percent.
The language of breast cancer treatment can be very confusing. In order to simplify the mystery, here is a list of the most common surgical procedures used to treat breast cancer and the reason they are used.
Lumpectomy – removing the cancer and providing evidence there is no disease left behind.
SLN biopsy (sentinel lymph node) – removing a minimal number of lymph nodes to determine whether the cancer has spread to the lymph nodes.
Nipple-sparing mastectomy – removing the entire glandular tissue of the breast but keeping the skin envelope as well as the nipple for a reconstructed breast that is cosmetically satisfying.
Skin-sparing mastectomy – a procedure where the breast as well as the nipple areola complex are removed, but the skin envelope is preserved for immediate breast reconstruction.
Oncoplastic repair after lumpectomy – rearranging breast tissue after removal of a large cancer which creates a smaller and cosmetically pleasing breast.
Breast Reconstruction – is a procedure performed after a mastectomy. It can be performed immediately after a mastectomy (immediate reconstruction) or it can be performed at a later date (delayed reconstruction) depending on the course of the breast cancer treatment.
There are three categories of reconstruction and all of these procedures are available to our patients.
- Implant based reconstruction is a procedure where glandular tissue of the breast is replaced by an implant.
- Pedicle flap is a procedure where the breast glandular tissue is replaced by the patient’s own tissue from a neighboring site. This tissue may come from the back or from the abdomen wall. These flaps are known as rotational flaps because in these procedures the blood supply of the flap is coming from the original site.
- Free flap is a procedure where the breast glandular tissue is replaced by the patient’s own tissue, but in these instances the flap is completely removed and re-positioned. This requires a surgeon who can perform microsurgery to rejoin the blood supply once the flap is re-positioned in the breast.
The newest addition to our breast cancer treatment is…
Hidden Scar™ Breast Cancer Surgery
Hidden Scar™ Breast Cancer Surgery is an advanced surgical technique applied to both mastectomies and lumpectomies. The surgeon removes cancerous tissue through an incision made in a discrete location, resulting in a hidden scar. By using this approach, surgeons are able to preserve a natural-looking breast, whether performing a lumpectomy or nipple sparing mastectomy.
Surgeons have been performing small hidden incisions for many years. The new advance is the ability to expand the number and type of patients this can be applied to. Newer equipment, training and a commitment to the patient’s cosmetic outcome make this procedure possible for many more patients. Patients who are interested in this technique should ask their surgeon whether it is the right choice for them.
Milford Regional is one of three hospitals in Massachusetts that is “certified’ as a Hidden Scar™ Center. To date there are only a handful of surgeons in Massachusetts who are certified to perform hidden scar surgery. The addition of hidden scar techniques at Milford Regional reaffirms our commitment to provide the most up-to-date surgical procedures to our breast cancer patients.
Read more about The Breast Center at Milford Regional.
Read more about our oncology services at Dana Farber/Brigham and Women’s Cancer Center at Milford Regional.
