At North Atlanta Breast Care, we diagnose and treat all breast-related diseases, coordinating care with other physicians and imaging specialists to provide a multidisciplinary approach to your care. Please browse below to learn about some of the procedures we provide, and be sure to ask Dr. Lairet or a team member of North Atlanta Breast Care if you have any questions.
An excisional biopsy is often done to further evaluate an area of abnormality on a mammogram, or a palpable mass that is thought to be benign. The area may not be obvious to your surgeon on physical exam and may require wire-localization by the radiologist on the morning of surgery.
Similar to a breast biopsy, a duct excision may be performed to remove an abnormal area in the breast duct system. The abnormal area may have been found on ultrasound or a ductogram (where dye is used by the radiologist to evaluate a particular duct in the breast) after a woman noticed discharge from her nipple.
A lumpectomy is also known as a partial mastectomy. Most often used to treat breast cancer, part of the breast tissue with or without the overlying skin is removed during a lumpectomy. The radiologist may localize the area to be removed by the surgeon by inserting a wire through the skin into the area of concern in the breast. This is done on the morning of surgery. If lumpectomy is performed for breast cancer, almost all patients will then undergo radiation therapy after the skin incision is healed.
Sentinel lymph node biopsy
A sentinel lymph node (SLN) biopsy is done to look for the spread of cancer into the lymph nodes in the axilla (underarm). On the morning of surgery, a radioactive tracer is injected near the breast tumor. The lymphatics in the breast then transport this substance to the “sentinel” or first lymph node in the axillary lymph nodes. The SLN is removed through a small incision at the base of your underarm. If you are having a mastectomy, the SLN is often removed through the same incision as the mastectomy. Your surgeon may also use blue dye during the surgery to help locate the SLN. The blue dye may cause temporary blue coloring of the skin of the breast, as well as turn the urine and bowel movements blue for a few days after surgery.
A mastectomy involves the removal of all breast tissue and sometimes the overlying skin and nipple. Your surgeon will discuss options for reconstruction of your breast with you during your preoperative office visits. After the breast tissue is removed and the remaining skin is closed, drains are often left under the skin. This helps to prevent accumulation of fluid under your incision. Your surgeon may perform a sentinel lymph node biopsy at the time of your mastectomy (see above). She may also perform an axillary dissection (see below). A mastectomy with an axillary dissection is called a “modified radical mastectomy”.
After having a mastectomy, many women choose to have reconstructive surgery. Federal law mandates that insurance companies must cover reconstruction for women having surgery for breast cancer. In many cases, reconstruction can be done at the same time as the mastectomy. While she will discuss breast reconstruction in general with all mastectomy patients, Dr. Lairet will refer you to a board-certified plastic surgeon to discuss the options for reconstruction in detail.
Axillary lymph node dissection
All of the lymph nodes in the axilla (underarm) are removed during an axillary dissection. This procedure is usually performed for patients with breast cancer that has spread to several lymph nodes in the axilla, or for circumstances described to you by your surgeon. If this procedure is performed along with a mastectomy, it will be done through the mastectomy incision. Otherwise, it is performed through an incision at the base of the underarm. After the lymph nodes are removed, a drain will be left under the skin to prevent fluid from building up under the incision. Potential complications of axillary dissection include nerve damage and lymphedema. Physical therapy is important after surgery and will be discussed with you by your surgeon.
Chemotherapy port placement
Your surgeon may place a port through which chemotherapy is given. Sedation is given in the operating room while your surgeon places a catheter into a large vein in your chest or neck. The port connected to the catheter, which is accessed by the chemotherapy provider, is placed beneath the skin.