Philosophy of Breast
Maryland Surgeons believes that the relationship between the patient and surgeon is
crucially important to receiving optimal breast care. The relationship begins
with the initial consultation. At the initial consultation, the patient
history is reviewed, the patient's statistical risk for breast cancer is
determined, imaging studies are reviewed with the patient and a physical
examination is performed. The surgeon's review of the imaging studies gives
the patient a second opinion interpretation of the studies. After all of the
information is considered, it is then determined if a diagnostic procedure is
indicated and if so, what procedure is optimal for each individual situation.
If a diagnostic procedure is required, the patient's surgeon will explain it
and then personally perform it. The patient's surgeon will contact the patient
to discuss the results of the procedure. If the result is that the patient is
found to have breast cancer, the relationship between the patient and the
surgeon will have already been established. This is crucial in helping the
patient make the difficult decisions required for successful treatment of
breast cancer. The surgeon will advise the patient on what further evaluation,
i.e. breast MR scan, is indicated and present the patient's case to the breast
cancer tumor board. The options for surgical treatment are thoroughly
discussed. Advice will be given concerning referrals to the medical
oncologist, radiation oncologist and plastic surgeon. Whatever treatment is
required, an established patient-surgeon relationship makes a difficult
situation the best it can be.
Our breast treatment and breast procedures include:
(mammographically guided) core breast biopsy
- Ultrasound guided
- Excisional breast
- Breast Conserving
- Sentinel lymph node
- Axillary dissection
- Simple mastectomy
- Modified radical
- Skin sparing
- Nipple sparing mastectomy
- All types of
reconstruction are performed by our plastic surgery colleagues
Frequently Asked Questions - Breast Procedures
Q. What is stereotactic (mammographically guided) core breast biopsy?
A. A core biopsy is a method of removing a specimen of breast
tissue about the size of a pencil lead through a very small incision. A
stereotactic core biopsy uses a special biopsy table and mammography to
precisely locate the coring needle into the area of the breast to be sampled.
It is a particularly useful technique for sampling areas of abnormal
micro-calcifications. The procedure is performed under local anesthesia and
takes less than an hour. The patient can drive herself to and from the
Q. What is sentinel lymph node biopsy?
lymph node mapping is a method of identifying the lymph node closest to the
breast. This lymph node has been named the sentinel lymph node. The sentinel
lymph node is the first lymph node that filters the fluid draining away from
the primary tumor. If cancer cells are breaking off and entering the lymph
system, the first filtering node will be most likely to contain breakaway
cancer cells. If the sentinel node is cancer free, the probability is high that
the cancer has not spread to any other node. This information is important in
staging the cancer and individualizing the cancer treatment
for maximum benefit. Identifying the sentinel node and removing it for
pathologic examination is a sentinel lymph node biopsy.
Q.What is a mastectomy?
A. Mastectomy is the surgical removal
of the breast for the treatment or prevention of breast cancer. There are
three main kinds of mastectomy: modified radical, simple and skin/nipple
sparing. In each case, all of the breast tissue is removed. In a simple
mastectomy, the nipple is removed with all the breast tissue. In a modified
radical mastectomy, the nipple is removed as well as the lymph nodes under the
arm. In a skin sparing mastectomy, as much of the skin of the breast is left
in place as possible to keep the original shape of the breast intact. A nipple
sparing mastectomy is a skin sparing mastectomy where the nipple is left
intact. The type of mastectomy chosen depends on the specific cancer being
treated, the preoperative shape of the breast and the wishes of the patient.
For more information on breast surgery or the breast
procedures we perform as they relate to diagnosis and treatment of breast
cancer, please visit Susan G. Komen
For The Cure
For more information on Breast Surgery please
contact us at (443) 574-8523.