Cardiovascular Associates PC

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Breast health continues to be one area of focus by our practice. Our physicians and staff understand that prompt care and answers ease anxiety. Our approach is to facilitate an appropriate evaluation, prompt results and coordinated treatment and follow-up. We share your desire for care, convenience and compassion. Diagnosis of Breast Masses and Abnormal Mammograms The role of a biopsy first and foremost should be to accurately establish a diagnosis. This most often can be done with a needle biopsy. On occasion, an area of abnormality needs to be removed with a surgical biopsy. Minimally invasive biopsies are usually needle biopsies and usually are our method of choice to establish a diagnosis. We prefer needle core biopsies as opposed to needle aspirations as they provide more tissue and thus a more accurate diagnosis. Most often, a needle biopsy is done with either ultrasound or mammographic guidance under local anesthesia. Ultrasound Guided Biopsies Ultrasound guided biopsies are performed in the office. These require only a small puncture site. Stereotactic Biopsy Stereotactic biopsy requires mammographic guidance and thus is not an office-based procedure. However, this can often be done the same day you are seen in our office. At times, a breast mass or abnormality may be present and not seen by ultrasound or mammogram. In these situations, a surgical biopsy is required. Also, some patients prefer for a mass to be completely removed rather than a needle biopsy. A surgical biopsy is an outpatient surgical procedure, most often done with local anesthesia. Treatment of Breast Cancer There are two issues to be considered with the treatment of breast cancer. First, how should the breast be treated. Secondly, should the whole body be treated, i.e. is there a need for chemotherapy. Breast cancer often can be effectively treated with less than a total mastectomy (removal of the breast), using lumpectomy and radiation therapy. Many factors are involved in deciding between breast conservation therapy and mastectomy. However, over 80% of patients are good candidates for breast conservation therapy. Sentinel Lymph Node Biopsy The most important predictor of prognosis for breast cancer is the status of the lymph nodes beneath the arm (axilla). The presence of cancer cells in these nodes indicates a much higher risk of recurrence. Fortunately, most patients do not have cancer cells in these lymph nodes. Previously to determine if these nodes contained cancer, a surgical procedure was performed to remove up to two-thirds of the axillary lymph nodes. Long-term side effects such as numbness and swelling of the arm, known as lymphedema, can occur with surgical removal of these nodes. Now a method is available that will identify the lymph node to which cancer cells would most likely spread. This node is excised and if it is without cancer cells, the patient is spared the more extensive removal of lymph nodes. Recently, a large multi-center study has confirmed the accuracy of the Sentinel Node Biopsy and its low complication rate. This is something we have known first-hand since 1999 when we started performing this procedure.

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