Breast Surgery

Our Approach to the Treatment of Breast Disease

We at Maryland Surgeons believe that the relationship between patient and surgeon is crucially important to providing top-notch and personalized breast care.

The relationship begins with an initial consultation in which the patient’s history is reviewed, the patient's risk for breast cancer is assessed, imaging studies are reviewed, and a physical examination is performed.  Considering all of this and other information, we generate a personalized recommendation regarding which, if any, diagnostic procedure is indicated.  If a diagnostic procedure is required, the patient's surgeon will explain it thoroughly, and we will assist with scheduling the procedure, be it a scan, a biopsy, or an operation.

If cancer is found and further treatment is necessary, the relationship between the patient and the surgeon will often, therefore, have already been established.  This is crucial in helping the patient make decisions required for successful treatment of breast cancer.  We will advise the patient on what further evaluation, such as a breast MRI scan, may be indicated, and will present the patient's case to the multidisciplinary breast-cancer tumor board.

We pride ourselves on discussing the options for surgical treatment thoroughly.  We will offer advice concerning referrals to the medical oncologist, radiation oncologist and plastic surgeon, as needed.  Whatever treatment is required, an established and excellent patient-surgeon relationship makes a difficult situation the best it can be.

We specialize in the following procedures:

  • Diagnostic Procedures
    • Stereotactic core biopsy (done by us or by a radiologist, as appropriate)
    • Ultrasound-guided core biopsy
    • Excisional breast biopsy 
  • Lymph-Node Procedures
    • Sentinel lymph node biopsy
    • Axillary dissection
  • Breast-Conserving Surgery
    • Lumpectomy
    • Hidden-scar breast surgery
    • Image-guided excisional biopsy
    • Biozorb placement
  • Mastectomy
    • Simple mastectomy
    • Modified radical mastectomy
    • Skin-sparing mastectomy
    • Nipple-sparing mastectomy
    • All types of reconstruction (performed by our expert plastic surgery colleagues)

Please contact us at (443) 574-8500 to set up an appointment or to get more information about how our surgeons can help you.

Frequently Asked Questions

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 procedure.

Q. What is sentinel lymph node biopsy?
A. Sentinel lymph node biopsy 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- and/or 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.

In Affiliation With Saint Agnes Healthcare

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For more than 150 years, Saint Agnes Hospital has been dedicated to the art of healing by providing exceptional care to the greater Baltimore area. Built on a strong foundation of excellent medical care and compassion, Saint Agnes is committed to providing the best care for our patients for many years to come.