In-Office & Surgical Procedures
Attention to detail in breast surgery makes all the difference in the outcome.
Attention to detail in breast surgery makes all the difference in the outcome.
Most abnormalities in the breast are able to be diagnosed based on a very small amount of tissue. This can be obtained through a low risk needle biopsy done in the office with minimal discomfort. The lesion must be visible by ultrasound for this procedure to be done in office. Results are reviewed with Dr. King as soon as they are available.
Book AppointmentThis procedure is typically done to drain fluid from a cyst or abscess. Some women require repeat aspirations or aspiration of multiple lesions. The fluid can be sent for testing and pathological evaluation if indicated.
Book AppointmentThis is a procedure to remove a small amount of tissue for evaluation and diagnosis by pathology. A small suture is used to close the tissue for healing. It is usually done to evaluate skin or nipple changes.
Book AppointmentUltrasound is the use of sound waves through tissue to evaluate different findings in the breast. It is invaluable as part of the clinical breast examination. The entire breast can be examined or just a targeted area of concern depending on your symptoms or needs.
Book AppointmentAn operation to remove cancer and preserve the breast, The cancer is removed with a rim of normal tissue around it called the margin. Most patients will need radiation after this surgery to prevent recurrence of the cancer.
Book AppointmentThis surgery combines the oncologic removal of cancer while rearranging the breast tissue to reshape the breast and prevent deformities. This typically requires an operation for symmetry on the other breast, which is done at the same time. Dr. King has additional fellowship training and extensive experience in these techniques.
Book AppointmentThis is a surgical procedure to remove the entire breast, skin and nipple. There are many approaches to the closure to suit a patient’s needs.
Book AppointmentThis type of mastectomy includes removal of the breast and nipple while preserving the skin envelope. It is done in the setting of breast reconstruction with a plastic surgeon who can recreate the breast with an implant, tissue expander (temporarily) or the patient’s own tissue.
Book AppointmentThis type of mastectomy includes removal of the entire breast gland but preserves the entire skin envelope, including the nipple. The incision is usually in the crease below the breast (inframammary fold). This is very safe, even in the setting of cancer as long as all of the cancer is removed.
Book AppointmentThis type of mastectomy utilizes all advanced techniques to preserve the entire skin envelope, nipple and the sensory nerves to the skin and nipple. The sensory nerve root is preserved by Dr. King and connected to a nerve graft by the plastic surgeon during the mastectomy and reconstruction. This operation offers the best chance at complete normalcy after breast reconstruction.
Book AppointmentThese are relatively minor operations done to remove benign lesions (fibroadenomas) or lesions that require clarification by obtaining more tissue (ADH, ALH, LCIS, discordant biopsies). The tissue removed is evaluated by the pathologist to ensure the lesion is benign. Attention to scar placement and closure of tissue is done to minimize scarring and prevent deformity of the breast.
Book AppointmentThis surgery is used to determine the diagnosis when a woman has concerning nipple discharge. Nipple discharge must be worked up when it occurs on its own (without pressure or squeezing), only comes from one side, or is bloody.
Book AppointmentPatients require this device to protect the smaller blood vessels in the arms while receiving chemotherapy. They are also known as “Mediports” or “Port-a-Cath”. They are usually only temporary and removed at the time of a later operation or in the office. Special attention to positioning of the port and skin closure are made to prevent unnecessary scarring.
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Dr. King offers all breast cancer surgical options including lumpectomy/partial mastectomy, mastectomy, port placement, sentinel lymph node biopsy and axillary node management. Surgical decision making is based on multiple factors including: patient age, stage of cancer, size of the tumor relative to the breast, overall size of the breast, symmetry and ultimately patient’s wishes.
For most women, survival from the cancer itself does not change based on the cancer operation as long as other treatments recommended are also done. If you are a candidate for breast preservation surgery, this will be reviewed in detail along with pros and cons to help you decide on the best operation.
You will have clear and thoughtful peri-operative education. With concierge surgery, your surgeon is more available to you to address concerns. At Serene, we also provide supportive therapy as a standard to help with post operative pain, scarring and mobility.
All surgery carries the risk of bleeding and infection. In cancer surgery, the biggest concern is the risk of “positive margins” meaning some cancer cells were touching the edge of the tissue removed. Meticulous detail when planning the operation by review of all data, utilizing advanced technology in the OR such as intraoperative specimen mammography and ultrasound and expert surgical skill are all the best way to avoid complications.
We usually understand whether or not lymph nodes are involved with cancer at the time of diagnosis with a full evaluation. For most women with breast cancer, a sentinel lymph node biopsy is done at the time of the breast operation. New data suggests women older than 65 with small, hormone responsive tumors can avoid sentinel lymph node biopsy. On the opposite end of the spectrum are those with advanced disease that require axillary node dissection. Each cancer diagnosis is different and recommendations will be discussed with each patient.
The appearance and sensation are least affected by a standard lumpectomy with thoughtful closure of the breast gland tissue and skin. Most women are numb after a mastectomy, which is why Dr. King offers the Sensation Sparing Mastectomy. Each patient’s expected results will be reviewed in detail.
For a standard lumpectomy, the recovery period is 1-2 weeks. For Oncoplastic lumpectomy with contralateral breast symmetry lift/reduction, the recovery period is 3-4 weeks. For mastectomy the recovery depends on the type of operation and reconstruction but averages 3-6 weeks.
Fortunately, most breast surgery is less painful than patients expect. The amount of pain also depends on the extent of the surgical procedure. Your expected level of pain will be reviewed along with planned medications and interventions.
Immediately after surgery, patients are usually seen 1-3 times for their postoperative care. Once you are well on the road to recovery, your visits will be spaced out and you can expect surgical surveillance for 1-2 years in six month intervals. This plan is fluid and can change based on your needs.
Dr. King will work with your other oncology care physicians to coordinate timing of treatments and surgery. Having concierge level care gives you comfort knowing that your care is coordinated effectively.