Surgery for breast cancer
UC Davis Comprehensive Cancer Center offers comprehensive, multidisciplinary care for patients with all stages of breast cancer aimed at preservation of critical functions, prevention of disease recurrence and optimization of quality of life. Your team of cancer specialists will include experts in hematology and oncology, surgical oncology, radiation oncology, pathology, plastic and reconstructive surgery, diagnostic radiology/mammography and genetic counseling.
Breast cancer is the most common type of cancer among women in the United States other than skin cancer, and is second only to lung cancer as a cause of cancer death in American women. Each year in the United States, more than 192,000 women are diagnosed with breast cancer. Over the past several years, however, deaths from breast cancer have decreased as cancer prevention, detection and treatment options have improved.
UC Davis Comprehensive Cancer Center recommends that women have regular clinical breast exams and mammograms to help find breast cancer early. Treatment is more likely to work well when breast cancer is detected early. Women should get regular mammograms every one to two years beginning at age 40. Women who are younger than 40 and have risk factors for breast cancers should consult with their health care providers about the frequency of mammograms or other screening methods.
If an abnormal area is found during a clinical breast exam or with a mammogram, the doctor may order other tests, such as imaging tests (an ultrasound or a Magnetic Resonance Imaging test, or MRI) or a biopsy.
Specific surgical procedures may include:
- Skin-sparing mastectomy: A skin-sparing mastectomy, or breast-conserving surgery, is a surgical technique that preserves the breast skin, or as much of the breast skin as possible, during a simple, modified or total mastectomy. During the procedure, the surgeon removes cancerous tissue through a small incision made around the areola; the surrounding breast skin becomes a “pocket” to then be filled with an implant or tissue from another part of the patient’s body. The skin-sparing procedure, for which most women are candidates, frequently offers the best option for a realistic and aesthetically pleasing reconstruction.
- Sentinel node biopsy: The "sentinel node" is the first lymph node to which the tumor would spread. A sentinel node biopsy is a highly specific and accurate form of lymph node sampling widely used in the cancer center for tumors with risk of lymph node involvement.
- Sentinel node mapping: This procedure determines whether the cancer has spread beyond the primary site and into the lymph system. The sentinel node is identified via injection of a blue and/or radioactive dye, and the node is subsequently removed.
- Breast conservation therapy: the use of lumpectomy in conjunction with postoperative radiation therapy.
- Oncoplastic surgery: to prevent the lumpectomy site from looking malformed or sunken if it is simply closed after removing the lump, breast tissue from other areas of the breast can be moved to fill in the area using oncoplastic surgical procedures.
Radiation therapy: This treatment uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. Radiation therapy can be given according to the whole breast, a treatment which can range from three to six weeks depending on risk factors, or over an accelerated time series that treats the area where the tumor started, primarily the lumpectomy site with a margin (accelerated partial breast radiation therapy).
Radiation may be required after mastectomy as well in patients with large (>5 cm) tumors, tumors that invade the skin or chest wall muscles, and in people with four or more lymph nodes with cancer. Radiation has been shown to minimize disease recurrence and improve survival in these patients.
There are two types of radiation therapy:
- External radiation therapy uses a machine outside the body to send radiation toward the cancer.
- Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires or catheters, which are placed directly into or near the cancer. The accelerated partial breast program uses this type of radiation.
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Oncologists Specializing in Breast Cancer
Mili Arora, M.D.
Helen Chew, M.D.
Director, Clinical Breast Cancer Program
Professor of Medicine
Scott Christensen, M.D.
Professor of Internal Medicine, Hematology and Oncology
Associate Director, Hospice Program
Medical Director, Cancer Care Network
Kendra Hutchinson, M.D.
Tianhong Li, M.D., Ph.D.
Associate Professor of Medicine
Eve Rodler, M.D.
Assistant Professor of Medicine
Richard Bold, M.D.
Chief of Surgical Oncology
Professor of Surgery
Candice Sauder, M.D., M.Ed.
Assistant Professor of Surgery
Shadi Aminololama-Shakeri, M.D.
Cyrus Bateni, M.D.
Terry L. Coates, M.D.
Professor of Radiology
Jonathan Hargreaves, M.D.
Karen K. Lindfors, M.D.
Professor of Clinical Radiology
Alexander Borowsky, M.D.
Associate Professor of Medical Pathology
Lydia P. Howell, M.D.
Chair and Professor of Pathology,
Department of Pathology and Laboratory Medicine
Lee L.Q. Pu, M.D.
Professor of Surgery
David Sahar, M.D.
Granger Wong, D.M.D., M.D.
Associate Professor of Surgery
Michael S. Wong, M.D.
Assistant Professor of Surgery
Megan Daly, M.D.
Danielle Baham, M.S., R.D.
Kathleen Newman, R.D., C.S.O.
Hereditary Cancer Program
Angela Usher, L.C.S.W., O.S.W.-C.