When it comes to breast cancer…you want to choose a surgeon that is progressive, knowledgeable, and compassionate. The breast surgeons at Premiere Surgical Specialists, Dr. Brian Juell, Dr. Alvaro Devia, and Dr. Thomas Rembetski have over 75 years of combined experience in breast surgery and are at the forefront of fighting the disease.
Every breast abnormality needs to be thoroughly evaluated. Just make an appointment! In our office, our physicians will use a detailed history, thorough physical exam, and appropriate imaging studies to evaluate abnormalities of the breast. Potential diagnoses include:
Benign Breast Lumps
Cysts – a common finding in many women. Simple cysts are a benign, non-cancerous finding. Large cysts which are symptomatic can be drained. Using our in-office ultrasound our physicians can drain cysts under local anesthesia, commonly at the time of your visit.
Fibroademas – common benign solid lumps, especially in younger women. If your physician feels that your lump may be a fibroadenoma, an ultrasound guided core-needle biopsy can often be performed in the office to confirm the diagnosis.
Breast Abcess – This is an infection of the breast with a collection of purulent fluid. Your physician may drain these using ultrasound guidance in the office. Alternatively, a small incision may be made in the office under local anesthesia to drain the infected fluid. Larger abcesses often require drainage by our surgeon in an operating room under general anesthesia.
Gynocomastia – this is a benign enlargement of breast tissue. This is often the cause of a breast lump in men. Removing the enlarged breast tissue is typically performed under general anesthesia in the operating room.
If your history, physical, and imaging suggest the possibility of breast cancer, a biopsy will be required to determine whether or not a cancer is present. Options include:
Sterotactic Biopsy – appropriate for lesions seen best on mammograms. These are generally performed by a radiologist. If a stereotactic biopsy is indicated, our office will work with you to make arrangements for one.
Ultrasound Guided Core Needle Biopsy – an ultrasound-guided core needle biopsy can be performed by our physicians in our office, many times during your first appointment, if indicated. Typically the results will be returned 1-2 days after the biopsy is performed.
Incisional or Excisional Biopsy – Occasionally a biopsy may need to be performed by our surgeons in the operating room under general anesthesia.
If a diagnosis of breast cancer is established, our surgeons will carefully explain your diagnosis and treatment options in great detail here in our office. The diagnosis of breat cancer can have many different aspects and treatment options. Our surgeons will ensure that you are well informed with regard to your diagnosis and treatment options. The majority of breast cancers will require a surgical procedure done by our surgeons in the operating room under general anesthesia. Surgical treatment options may include:
Partial Mastectomy – this involves removing the cancer with a rim of surrounding normal breast tissue. The rest of the breast is preserved and reconstructive procedures are often not necessary.
Total Mastectomy – This involves removing all of the breast tissue on the site of the cancer. Many patients have the option of either immediate or delayed Breast Reconstruction by a Plastic Surgeon, now a covered benefit by all insurances. Our office works closely with many Plastic Surgeons in the area. We can also refer you to the Plastic Surgeon of your choice. We will work with your Plastic Surgeon to coordinate surgery to make the process as comfortable and convenient to you as possible.
Lymph Node Removal – Frequently removing Lymph Nodes is an important part of your Breast Cancer treatment and staging. When appropriate, the Sentinel Lymph Node technique is used to reduce the number of lymph nodes that are removed and improve recovery.
Based on the results of your Breast Cancer surgery, additional treatment may be required or recommended. Our physicians work closely with Medical Oncologists and Radiation Oncologists regarding additional treatments that may be required and will ensure that you see the appropriate physicians in consultation. Many women who require radiation may be candidates for partial breast irradiation. This often shortens the time required to give the recommended radiation. For most women who choose partial breast irradiation, the required catheter for the delivery of the radiation can be placed in our office under ultrasound guidance.For more information on this treatment, please click here.