Breast Cancer

Comprehensive Breast Center

PeaceHealth Longview Surgical Group physicians work with radiologists, oncologists, radiation oncologists, pathologists, and nursing support in a collaborative effort with the Columbia Regional Breast Center, the Lower Columbia Cancer Center, and OHSU to help women with breast-related problems. Patients with abnormal mammograms or breast lumps are referred to our office for evaluation or follow-up. Most breast lumps or abnormalities are not cancerous.

Breast Care Management Team
Expertise of many specialists, including physicians, surgeons, nurses, pathologists, radiation oncologists, oncologists and radiologists is needed in the accurate diagnosis and optimal treatment for breast cancer. PeaceHealth Longview Surgical Group physicians meet with a Breast Care Management Team of specialists biweekly to review the cases of newly diagnosed breast cancer patients. A group recommendation is made and discussed with the patient.

Breast Biopsy
Most breast lumps or abnormalities can be biopsied in the office. There are many options for biopsy of a questionable area in the breast. Often, the surgeon will perform a breast ultrasound that can help evaluate the area and provide more information before a biopsy is considered. Breast ultrasound is done by applying a warm gel to the breast and then passing a smooth probe over the skin of the breast. This allows the surgeon to see the breast tissue on a video screen.

Fine needle aspiration is used to biopsy lumps or abnormalities by first locating the area using the breast ultrasound and then a very small needle can be directed into the breast to sample (withdraw some cells) of the area. For a core needle biopsy a local anesthetic numbs the area and a small piece of breast tissue is taken using a special needle. This procedure can be done with ultrasound guidance or with a special table and computerized system called stereotactic biopsy. An excisional biopsy is done when the surgeon numbs the area using a local anesthetic and removes the entire lump. The surgeon may determine that an excisional biopsy would be best performed in the hospital. If the biopsy is done in the hospital, you would usually go home in a few hours or the same day. The biopsied samples of tissue are sent to be examined by a pathologist under a microscope. The results of the biopsy would be discussed with you in a follow-up office visit. This is an advanced state-of-the-art evaluation, which gives women more opportunity for a breast saving surgery in the event cancer is detected and additional surgery is needed.

Mastectomy
There are several different types of mastectomies (breast removal surgery). A lumpectomy (or Segmental Mastectomy) removes the lump and some normal tissue surrounding the lump. This procedure will preserve your breast and is typically done when the lump is small and cancer has not spread to the rest of the body. A Simple Mastectomy removes just the breast and not any lymph nodes. A Modified Radical Mastectomy removes the breast and samples some of the lymph nodes under the arm (in the axilla) on the same side as the breast cancer. Sentinel node biopsy is a new procedure that may allow the surgeon to remove only one or two lymph nodes under the arm during either lumpectomy or modified radical mastectomy surgery. Your surgeon and breast care management team will recommend the procedure that is best for you based on the specifics of your individual case.

Breast Reconstruction
Reconstruction is an option for most mastectomy patients. Reconstruction can often occur or begin at the same time as your mastectomy. The most suitable type of reconstruction for you is determined by your body type, your age and the type of treatment you have had for cancer. Our plastic and reconstructive surgeon will work with the breast cancer surgeon to recreate the best possible shape of your breast and help match the size and shape of your remaining breast. Living tissue from another part of the body, typically the abdomen, can be used to create a breast shape without implants. Other flaps can be used when a woman does not have enough skin or muscle to cover an implant. Implants are sacs filled with saline (salt water) and surgically inserted. Expanders stretch the skin on the chest to allow the implant more room. Over a period of weeks the expanders are slowly enlarged by injecting saline.

Compassion. Precision. Confidence.