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(509) 228-1000 WA
(208) 754-3100 ID

Breast Surgical Oncology at Cancer Care Northwest

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CCNW Breast Surgical Oncologist, Dr Moline, discusses surgical options with patient
 

Most women with breast cancer undergo some form of surgery as part of their treatment. The type of breast surgery varies based on each individual's cancer diagnosis, staging, overall health, and any previous treatments. At Cancer Care Northwest, our team of experienced breast surgeons and specialists are dedicated to offering personalized, comprehensive care tailored to each person's unique needs. Additionally, if a treatment plan requires it, breast cancer patients have access to CCNW's comprehensive cancer treatment options, including medical oncology, radiation therapy and genetic testing.

To schedule an appointment with a CCNW breast surgical oncologist, please call (509) 228-1000.

 

Breast Conditions We Treat

Cancer Care Northwest specializes in the treatment of the following benign and malignant breast conditions:

  • Angiosarcoma of the breast
  • Apocrine breast cancer
  • Atypical ductal hyperplasia
  • Atypical lobular hyperplasia
  • Ductal Carcinoma
  • Ductal Carcinoma in situ (DCIS)
  • Family history of breast cancer
  • Genetic risk for breast cancer
  • HER2 positive breast cancer (HER2)
  • Hormone receptor positive breast cancer (ER+ or PR+)
  • Inflammatory breast cancer
  • Invasive ductal carcinoma (IDC)
  • Invasive lobular carcinoma (ILC)
  • Lobular carcinoma in situ
  • Medullary breast cancer
  • Metaplastic breast cancer
  • Micropapillary breast cancer
  • Mucinous breast cancer
  • Nipple discharge/papilloma
  • Papillary breast cancer
  • Paget disease of the breast
  • Phylloides tumor
  • Triple-negative breast cancer
  • Tubular breast cancer

 

Excisional Biopsy

This surgery involves the complete removal of suspicious breast tissue to either prevent potential cancer or confirm a diagnosis. The aim is to remove all suspicious tissue while preserving as much healthy tissue as possible. Common breast conditions that may require an excisional biopsy include atypical ductal hyperplasia, papillomas, fibroadenomas, and radial scars.

 

Lumpectomy

Also known as a partial mastectomy or breast conservation surgery, lumpectomy is a surgical procedure that removes all the breast cancer along with a small margin of healthy tissue surrounding it to ensure all affected areas are removed.

When cancer is removed via lumpectomy, radiation therapy typically follows to lower the risk of recurrence.

A lumpectomy may not be an option in cases where negative margins cannot be achieved, or the patient underwent prior radiation to the chest wall.

 

Mastectomy

A mastectomy is a surgical procedure used to treat breast cancer by removing all the breast tissue in one breast (unilateral mastectomy) or both breasts (bilateral mastectomy or double mastectomy). There are various types of mastectomy options tailored to each patient's specific breast-health needs.

  • Simple Mastectomy: Also known as a total mastectomy, this is the surgical removal of the breast, nipple, and most of the overlying skin. An aesthetic flat closure is achieved, meaning that the chest wall is flat and there is an incision from the sternum to the underarm.
  • Skin-Sparing Mastectomy: This approach removes the breast tissue and nipple while preserving most of the overlying skin. The nipple is removed when cancer is too close, or blood flow issues prevent healing. Optional nipple reconstruction or tattooing can be done later. A skin-sparing mastectomy is combined with breast reconstruction, performed by a board-certified plastic surgeon. The retained skin allows for a reconstructed breast mound and gives the breast a more natural appearance after surgery.
  • Nipple-Sparing Mastectomy: In this procedure, the breast tissue is removed while keeping the skin, nipple, and areola intact. This option is combined with breast reconstruction, performed by a board-certified plastic surgeon.
  • Modified Radical Mastectomy: This procedure removes the breast along with most of the lymph nodes in the axilla (underarm area).
  • Radical Mastectomy: This involves the removal of the breast and part of the chest wall, along with the lymph nodes in the axilla (underarm area). Due to advancements in breast cancer treatment, it is now rarely performed.

A mastectomy can be done with or without breast reconstruction, which can be done at the same time, shortly after, or several months to a year later, depending on the plastic surgeon's plan. The two main reconstruction methods are using tissue from another part of the body, such as DIEP Flap reconstruction, or an implant. This process adds time to surgery and recovery, and patients must meet specific criteria to qualify for breast reconstruction.

When cancer is removed via a mastectomy, the need for post-surgical radiation therapy will depend on a patient's pathology report and will be determined by your CCNW care team.

The decision to undergo a mastectomy depends on factors such as tumor size, breast size, cancer location, and your ability to receive radiation therapy. At Cancer Care Northwest, we are committed to providing you with the most suitable treatment for your breast cancer care.

 

Lymph Node Surgery

When breast cancer spreads, it often reaches the underarm lymph nodes, or axilla, first. Surgery may be needed to check if the cancer has spread beyond the breast, though in some early cases, this is unnecessary. The breast surgeon will recommend underarm surgery based on the individual case, and the type of breast surgery chosen usually doesn't affect this decision.

Here are the common axillary surgeries:

  • Sentinel Lymph Node Biopsy: Involves removing one or more lymph nodes when they look normal on pre-surgery imaging. It's done to check if a tiny amount of cancer has spread into an otherwise normal appearing lymph node. If cancer is found, additional nodes may be removed, though this depends on various factors.
  • Axillary Lymph Node Dissection: Involves removing all the lymph nodes in the axilla and is a less common surgery that may be required in certain cases.
  • Targeted Axillary Dissection: This surgery is performed in cases where a lymph node already has cancer. After targeted chemotherapy is given to shrink the tumor, the affected node, as well as the sentinel lymph node, are surgically removed. If cancer remains, more nodes may need removal.

Surgery in the axilla can cause scarring and damage to the arm's lymphatic system, as arm and breast lymph nodes intersect in this area. Damage to arm lymph nodes may lead to fluid buildup and swelling, known as lymphedema. At CCNW, our goal is to fully remove and cure breast cancer without compromising the lymphatic system. Whenever possible, we take extra precautions to reduce the risk of lymphedema.

 

Meet CCNW's Breast Cancer Surgeons

Fighting cancer with surgery is what Cancer Care Northwest's fellowship-trained surgical oncologists know and do best. Cancer Care Northwest's breast cancer specialists are highly trained in the most advanced surgical treatments for the diagnosis, staging and treatment of breast cancer.

Dr. Michalina Kupsik, MD
Board-Certified Surgical Oncologist
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Jennifer Lazzara, DNP, ARNP, CGRA
Nurse Practitioner
Cancer Generic Risk Assessment Certified
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Dr. Stephanie Moline, MD, FACS
Board-Certified Surgical Oncologist
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Dr. Maryam Parviz, MD, FACS
Board-Certified Surgical Oncologist
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Schedule An Appointment

When you've been diagnosed with breast cancer, we understand time is of the essence. To schedule an appointment with a CCNW breast surgical oncologist, please call (509) 228-1000.