Regular mammograms, breast self-exams and check-ups by a specialist are always a woman's first line of defense in the battle against breast cancer. But what happens if a lump or suspicious mass is detected? That answer has changed a lot in recent years.
"Open surgery used to be the only answer," says Dr. Firooz Taghizadeh, General Surgeon at Uniontown Hospital. "Now there are alternatives that are less invasive and just as effective."
Stereotactic Biopsies
Determining whether the lump or mass is cancerous is the first step. Usually, a biopsy is recommended. "Today, we're able to perform stereotactic breast biopsies as an alternative to open surgical biopsies," Dr. Taghizadeh states. "This new tissue sampling technique can be done on an outpatient basis, and is very accurate when skillfully performed."
Stereotactic biopsies remove tissue from lumps and lesions through a hollow needle inserted into the breast. The needle is guided with the help of special X-rays. "Stereotactic" means that the biopsy path is imaged from two slightly angled directions to help specialists guide the needle more precisely.
"X-ray guided biopsies are an excellent way to evaluate small masses that aren't visible on ultrasound," says Dr. Taghizadeh. "They're also ideal when a mammogram has detected a mass, but no lump can be felt."
"Besides being highly effective, the procedure has many benefits. It only takes 30 to 60 minutes to perform, and most women report little to no pain. No scar is left from the tiny incision, and women can resume their normal activities in just 24 hours."
Breast Conserving Surgery
If a mass is found to be cancerous, many women automatically think "mastectomy." But thankfully, times have changed. "Today, whenever possible, we use targeted surgery to preserve as much of the healthy breast as possible," says Dr. Taghizadeh. "Research shows that a lumpectomy with follow-up radiation therapy is every bit as effective at treating small, early-stage tumors as a mastectomy."
"Where a mastectomy removes the whole breast, a lumpectomy removes only the tumor. We usually recommend radiation therapy as well, to ensure that there is no cancer left in the breast, and to reduce the possibility of a recurrence."
"Studies show that survival rates are the same whether a woman has a mastectomy or breast-conserving surgery with radiation," says Dr. Taghizadeh. "So lumpectomies are not only less disfiguring, but patients can feel confident that they've made a safe choice."
Breast preservation techniques, such as lumpectomies with radiation therapy, are recommended by the National Cancer Institute over mastectomy for women with small, early-stage cancers.
Sentinel Lymph Node Dissection
Often times, if a woman is found to have breast cancer, her doctor will recommend removing some lymph nodes to determine whether the cancer has spread.
"Lymph nodes filter fluid draining away from the breasts," explains Taghizadeh. "If cancer cells break away from a tumor, they travel away from the breast via the lymph system."
"Sentinel lymph node dissection is a new and exciting alternative to more invasive auxiliary lymph node dissection," says Taghizadeh. "In auxiliary dissections, surgeons remove 10 or more nodes for analysis. Sentinel dissection means the surgeon takes just the first two or three nodes - the 'sentinels' or guardians - to the lymph system. If these first nodes are clean of cancer, then it's reasonable to believe that the following nodes will not have been affected."
Lymph node removal usually occurs at the time of a mastectomy or lumpectomy, but in some cases, it is a later operation. Once the nodes are removed, a pathologist dissects them, searching for signs of cancer.
"Sentinel lymph node dissection is another great example of how breast cancer care has progressed to become less invasive, without any loss of safety or effectiveness."
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