Breast Center Programs & Services

We use 3D mammograms to effectively pinpoint the size, shape and location of potential breast abnormalities. Mammography is a detailed radiograph of the breast. It creates an image of the tissue inside the breast and is used to identify lumps, tumors, or other abnormalities that are too small to find by touch alone. A screening mammogram is a routine test to look at breast tissue without any physical abnormalities or symptoms. Standard images of the breast are obtained. It can detect a cancerous or precancerous finding before it can be found on clinical examination. It will also serve as a baseline for future mammograms. A diagnostic mammogram is done to evaluate physical findings or symptoms noted by the patient or her physician. Standard images are obtained as well as ones focused on the area in question. To obtain a good picture, the breast is compressed firmly to keep it from moving. Sometimes the patient’s breast is repositioned and additional pictures are taken – do not be concerned. It is common for patients to need additional studies such as ultrasound or breast MRI.

A Breast MRI uses a powerful but harmless magnetic field to create an image of the body. This involves no x-rays or radiation. This method of imaging is complimentary to mammography and ultrasound. An abnormality found on MRI may require a focused ultrasound based on the location of the abnormality on MRI. If it is seen on ultrasound, a biopsy may be done using ultrasound. If it is not seen by focused ultrasound, a MRI guided biopsy will be scheduled or an appropriate follow up given.

An ultrasound uses high-frequency sound waves to create pictures of the body. Ultrasound can also be done of the axilla (arm pit) to assess lymph nodes. It sends out sound waves into your body and collects them after they bounce off tissues. A computer collects these sound waves and creates an image of the tissues. The change from known normal tissue characteristics to abnormal can be interpreted by the radiologist to further define the abnormality.

A core biopsy is a minimally invasive procedure to determine the pathology (diagnosis) of an abnormality or finding (on mammogram, ultrasound, or MRI). A small tissue sample is obtained with a needle. The sample is then sent to the pathologist to be examined. Results of the biopsy will be given to you within 2-3 business days (48-72 hours).

Oncotype DX is a diagnostic tool that allows the medical oncologist to target therapy specific to your tumor and your needs. The tumor that is removed in women who are sentinel node negative and demonstrate estrogen receptors in the tumor cells can have this test performed by evaluation of 21 genes present in their cancerous tumor. Statistical methods are then used to generate a recurrence score. If your recurrence score is low, you may only require endocrine therapy (Tamoxifen or Aromatase inhibitors) as this treatment gives the greatest effect to reduce recurrence. If the recurrent score is high then chemotherapy gives the greatest benefit but adding endocrine therapy produces additional benefit.

Surgeons can remove significant portions of the breast tissue utilizing oncoplastic techniques allowing for breast preservation to minimize the indentation or depression created by removing tissue. Breast Conservation Surgery consists of lumpectomy, partial mastectomy, and wide local excision. The terms are used interchangeably. The procedure is usually followed by radiation therapy to the affected breast.

Women who have undergone mastectomy for breast cancer have many options for breast reconstruction. The best option for you depends on your personal medical history and preferences. Our plastic surgeon works with our breast surgeons to coordinate each patient’s personalized surgical plan. Options include rearrangement of breast tissue, reduction in breast size, and implant placement.

In addition to surgical treatment, chemotherapy is used to further decrease the chance of a malignancy coming back in the breast or body generally. There are certain drugs which are considered standard of care. However, clinical trials are available should you meet certain criteria and desire participation.

Our surgeons are trained in Hidden Scar Surgery, an advanced approach to removing breast cancer or your risk of breast cancer. The Hidden Scar approach allows your surgeon to make the incision is placed in a location that is hard to see, so your scar is not visible when it heals.

Other prognostic tests available and offered at BID Plymouth include Growth Factor Receptor (HER2). If this indicator is present in the cancerous tumor, it will allow targeted therapy with use of a new drug, Herceptin. This is known as immunotherapy/biological therapy.

Mastectomy with or without breast reconstruction is removal of all breast tissue including the nipple areolar complex. Some rare exceptions can be made.

Radiation therapy is usually used in conjunction with breast conservation surgery as this is known to increase local control and help prevent cancer from recurring in the same breast. The standard of care is whole-breast and limited breast irradiation. However, other options will be discussed including hypofractionated irradiation. Your radiation therapist will discuss this in detail with you.

Sentinel node excision may be used with either breast conservation or mastectomy procedures. Lymphatic mapping is a sophisticated method of identifying the first lymph nodes (usually 1-3) that drains the tumor. This is called the sentinel node. This procedure demonstrates sentinel nodes in the axilla (arm pit) on the same side as the affected breast. The sentinel node(s) are removed and evaluated at the time of the breast conservation surgery or mastectomy. A sentinel node which contains cancer cells indicates more complete surgical dissection of the axilla. A sentinel node without cancer cells does not require more extensive surgery.