At the Mass General/North Shore Breast Health Center, multidisciplinary teams of breast surgery experts evaluate and diagnose conditions from benign breast disease to breast cancer. Working in concert with experts from the Mass General/North Shore Cancer Center and the Mass General Cancer Center, they map out an individual course of treatment tailored to each patient’s specific needs and diagnosis. In addition, they work in tandem with plastic surgeons to provide the best options for breast reconstruction, if necessary. Immediate reconstructive (plastic) surgery is possible in nearly all patients.
Mass General/North Shore Breast Health Center surgeons are specially trained to treat breast cancer. They perform:
Surgical breast biopsy
During a surgical biopsy, a breast surgeon will remove a sample of the lump or the suspicious area in the breast and send it for evaluation by a specialized pathologist. This biopsy may be aided by a pre-operative needle localization procedure, in which a breast radiologist uses mammographic or ultrasound guidance to place a thin localizing wire into the tissue to target the area to be biopsied. Surgical breast biopsies are outpatient surgical procedures, usually taking about one hour.
Surgery, chemotherapy and radiation treatment
Surgeons at the Breast Health Center work collaboratively with medical oncologists and radiation oncologists at the Mass General/North Shore Cancer Center to plan out the best course of treatment for each patient. In many cases, chemotherapy and/or radiation therapy may be required after surgery and can be provided here at the Mass General/North Shore Cancer Center.
Sentinel lymph node biopsy
Our Breast Health Center surgeons use the most advanced techniques for the surgical treatment of breast cancer. Part of the evaluation of patients with invasive breast cancer is the testing of lymph nodes in the areas surrounding the breast to see if cancer has spread outside of the breast. Knowing whether tumor cells have spread to lymph nodes helps guide recommendations for treatment, including chemotherapy, hormonal therapy and radiation therapy.
Lymphatic mapping with sentinel-node biopsy removes only the lymph nodes closest to the breast, which are the ones most likely to harbor cancer if the cancer has spread. By sparing most of the lymph nodes in the armpit area, there is a much lower risk of lymphedema, or arm swelling.
Breast reconstruction surgery
For women who prefer reconstruction after mastectomy, our breast cancer surgeons work closely with plastic and reconstructive surgeons to evaluate the woman’s goals, medical history, physical condition and potential need for additional cancer treatment to decide on the best type of reconstruction for each patient.
Our breast reconstructive surgeons can offer women a number of reconstructive options, most of which can be done at the time of the mastectomy. Our breast surgeons have expertise in performing skin-sparing and nipple-sparing mastectomies.
Implant-based reconstruction may be performed in a single-stage procedure in which the permanent breast implant is placed at the time of mastectomy. Alternatively, a two-stage procedure may be performed. In a two-stage reconstruction, a saline-filled tissue expander is placed into the site of the removed breast. After surgery, the tissue expander is gradually filled over a series of office visits until the desired volume is reached. Once this is done, the tissue expander is surgically removed and a permanent breast implant, either saline- or silicone-filled, is placed in the cavity created by the expander.
Another method of reconstruction involves transferring tissue from the abdomen or back to construct a breast from the patient’s own tissues. With most forms of reconstruction, either the patient’s original nipple is spared and reattached or her skin is used later to reconstruct a nipple, which is subsequently tattooed the same color as the other nipple.
Learn more about the Plastic and Reconstructive Surgery Service at the Mass General/North Shore Center for Outpatient Care