While a breast cancer diagnosis can be scary, our experienced breast cancer team in Worcester and central Massachusetts can provide surgery to remove the cancer and may possibly improve the chances of a positive health outcome following the diagnosis. The team at Saint Vincent Medical Group will determine the best course of action to diagnose and remove cancer in the breast.

When to see a breast surgeon

Women should conduct monthly breast self-exams and pay attention to changes in their breasts. Talk with your primary care physician or your OB/GYN about when you should start having an annual mammogram, a special X-ray of the breast that can show growths that are too small to feel with your fingers during self-exam. Contact your primary care physician or your OB/GYN if you detect changes such as:

• Lumps in the breast or underarm
• Skin on the breast appears to be pulling inward or puckered
• Breast pain
• Redness or thickening of the nipple or breast skin
• Change in the size or shape of the breast
• Anything that looks or feels different

Your primary care doctor or OB/GYN will refer you to a breast surgeon if a mammogram or other diagnostic test indicates you have a breast health issue. Surgery may range from a breast conserving procedure known as a lumpectomy to a mastectomy in which the entire breast is surgically removed. Your breast surgeon will review your surgical options as well as the possibilities for breast reconstruction, should you choose to undergo that procedure.

Procedures

• Lumpectomy: A lumpectomy is the surgical removal of a cancerous or noncancerous tumor in the breast, as well as a small amount of normal breast tissue around a cancerous tumor. This surgery is also sometimes used to rule out a cancer diagnosis, and the recovery time for a lumpectomy is about a month. A lumpectomy is also sometimes referred to as a partial mastectomy, breast-conserving surgery, breast-sparing surgery, or wide excision. This surgery conserves most of the breast tissue and generally keeps the shape and appearance of the breast. It is commonly used to treat small, early-stage breast cancer. A lumpectomy is usually followed by radiation therapy to reduce the chances of the cancer returning, and lymph nodes may also be removed during the surgery to determine whether the cancer has spread.
• Mastectomy: A mastectomy is the removal of the entire breast to treat breast cancer or to reduce the chances of getting breast cancer. A physician may recommend a mastectomy instead of a lumpectomy with radiation if:
• There are two or more tumors in separate areas of the breast.
• There are widespread or malignant-appearing calcium deposits throughout the breast that have been determined to be cancerous following a biopsy.
• Cancer has recurred in the breast after radiation therapy.
• The patient is pregnant, and radiation can put the unborn child at risk.
• Cancer is still present following a lumpectomy and there is concern about cancer spreading to other parts of the breast.
• The patient carries a gene mutation that makes the risk of cancer developing in the breast a second time very high.
• The tumor is large in relation to the breast itself.
• The patient has a connective tissue disease that will make them intolerant to the side effects of radiation to the skin.
• Removal of Lymph Node: When breast cancer occurs, there is a possibility that it can spread to other parts of the body. If it does spread, the first area that is usually affected is the nearby lymph nodes. Before surgery, ultrasound may be used to check the lymph nodes for cancer cells, and a biopsy will typically be taken of any lymph nodes that look abnormal. If an ultrasound does not show any abnormal cells prior to breast cancer surgery, then a sentinel lymph node biopsy will be performed during the surgery to check to see if cancer has spread to the nearby lymph nodes. If cancer is found in the lymph nodes that are removed during breast cancer surgery, then further treatment of the lymph nodes under the arm may be needed. When it is needed, further treatment can include radiation, or further surgery to remove more nodes.
• Image Guided Biopsies: Advances in technology have made breast biopsies less invasive - reducing the amount of recovery time and leaving little to no scarring after. These procedures include MRI-guided, ultrasound-guided, and stereotactic breast biopsies.
• Nipple Sparing Surgery: A nipple sparing surgery is a mastectomy in which the nipple is left intact, leaving a more natural-looking breast after the surgery. During this surgery, the breast tissue is removed, but the breast skin and nipple are left in place. Almost always, this surgery will be followed by breast reconstruction. This surgery can be an option for patients with small, early-stage cancer near the outer part of the breast, with no signs of cancer near the nipple.
• Immediate Breast Reconstruction: Immediate breast reconstruction is surgery that is performed at the same time as a mastectomy. After the breast is removed, it is reconstructed either with tissue from another location on the body, with an implant, or sometimes with both. Immediate reconstruction may not be possible if additional treatments such as chemotherapy or radiation are needed after surgery, or part of the reconstruction may be performed during the mastectomy, with the remainder of it completed after chemotherapy or radiation. If a mastectomy is being performed as a preventive measure for a patient with a high risk of developing breast cancer, typically the reconstruction is performed immediately.

All procedures are performed by our team at Saint Vincent Hospital.