Mount Kisco Medical Group, P.C. : Surgery

MKMG's Breast Surgeons

Carl F. Calica MD FACS	IHOR JOHN CEHELSKY MD FACS
BARRY A. KASSEL MD FACS	MAUD L. LEMERCIER MD
AMANDA MESSINA MD	MARIA PENCE MD
LYDA E. ROJAS MD	Adam B. Semegran MD

Breast Surgery
Breast cancer treatment includes treatment of the breast and treatment for cancer cells that may have spread to other parts of the body. Surgery is the first step in the treatment of early breast cancer.

Breast Cancer surgery involves removing the abnormal tissue in the breast, with either breast conservation surgery or mastectomy, and evaluating lymph nodes in the axilla (underarm).

Breast conservation surgery involves a lumpectomy followed by radiation therapy. A surgical lumpectomy removes the cancer cells and a margin of surrounding normal tissue through a cosmetically oriented incision. Surgery is performed as an outpatient procedure. For extremely small cancers, a patient may have the abnormal area identified by a radiologist immediately prior to surgery. This involves having a thin wire placed in the breast using imaging to target, or localize, the abnormal area. If radiation therapy is necessary, it is typically given starting approximately a month after surgery as part of the complete treatment.

Mastectomy is when all of the breast tissue from the affected breast is surgically removed. If a woman has a mastectomy she may want to consider breast reconstruction either immediately or shortly thereafter. During a consultation, the surgeon will review options with a breast cancer patient, to decide which choice is best for her individual situation. Whenever possible, breast conservation surgery is offered.

Lymph Node Surgery

As part of treatment it is important to determine whether lymph nodes are involved. If a woman's lymph nodes have been affected there is an increased chance that the cancer cells have spread to other parts of the body. The only way to determine if lymph nodes have been affected is to examine them under a microscope.

A sentinel lymph node biopsy is a minimally invasive procedure to examine the underarm lymph nodes. At the time of surgery, the surgeon injects a radioactive tracer and blue dye into the breast. The tracers follow the microscopic lymph flow of the breast tissue to the axillary nodes. The sentinel nodes (usually 1-3 nodes) are removed through a small incision in the underarm, and then examined microscopically.

If the sentinel node contains cancer, the surgeon will remove additional lymph nodes (axillary lymph node dissection). If the sentinel nodes are clear, then no further lymph node surgery is needed.