Dr. Bonefas offers many of the latest surgical techniques to offer various options to her patients.
All in-office procedures are done under local anesthesia and most women can return to work the next day and resume normal activity. These procedures are considered non-surgical and are minimally invasive. All biopsies are sent to pathology for accurate diagnosis with results usually within 48 hours.
Ultrasound uses soundwaves or sonography to visualize breast tissue including breast tissue abnormalities, such as a cysts or lumps. Ultrasound is used when performing image-guided breast biopsy if the doctor cannot feel the lump. Ultrasound is a non-invasive procedure and does not require any special preparation.
When a lump can be felt, a needle biopsy may be performed. Fine needle aspiration uses a needle to draw cells and/or fluid from the lump. Core needle biopsy uses a larger needle that takes samples of breast tissue.
Vacuum Assisted Biopsy:
This technique can be done in the office instead of the operating room. This breast biopsy procedure uses a special vacuum-assisted probe to collect tissue samples. The procedure takes less than one hour and only requires a small incision about 1/4 of an inch or the size of a pencil eraser. A marker may be placed at the biopsy site to identify the area for future mammograms or for surgery if the lump is malignant. Results are as accurate as a surgical biopsy. You are able to drive yourself home and return to work the next day.
This technique uses x-ray to locate and biopsy the area of calcifications seen on amammogram but not traditionally found as a lump. Several core samples are taken of the area by using a core needle or vacuum-assisted probe biopsy. This may be scheduled at an imaging facility.
Balloon Radiation Therapy:
This is a new accelerated partial breast radiation therapy technique which is appropriate for selected patients undergoing lumpectomy for breast cancer. After lumpectomy, a balloon is placed in the lumpectomy site cavity. The radiation will be placed by your oncologist. Radiation therapy can be completed in 4-6 days instead of the traditional 4-6 weeks and requires no body markings.
Breast brachytherapy is an approach that uses radiation to treat the lumpectomy cavity and the surrounding tissue from within the breast. This treatment is the latest advancement in the delivery of radiation treatment for women with early-stage breast cancer. A brachytherapy applicator is placed by the surgeon and then your radiation oncologist is able to precisely target the dose to where you need it most.
Cryoablation is a procedure for breast fibroadenomas. This is a non-surgical method of eradicating tumors without compromising the shape and size of the breast. A small probe is inserted leaving no visible scarring. This procedure requires local anesthesia and patients can return to normal activities the same day.
Breast Surgeries as an Outpatient:
Breast cancer surgeries are done under general anesthesia and usually require two to three hours. Usually you may go home the same day of your surgery but will need a designated driver.
Excisional Breast Biopsy
This biopsy includes surgical removal of the entire lump and microscopic evaluation of the tissue. If a rim of normal tissue is taken all the way around the lump, it is called a lumpectomy, and then the biopsy can serve as part of the cancer treatment (removal of the cancerous tumor).This is sometimes done with needle wire localization and x-ray. A wire is placed into the area to be biopsied. X-ray confirms proper placement. The wire then serves as a guide to locate the abnormal tissue to be removed.
This is a new innovative ultrasound-guided soft tissue excision devise that utilizes a unique RF-powered loop. This procedure is intended to facilitate precise tissue removal while significantly reducing procedure time and improving cosmetic outcomes.
This procedure is done in the operating room as an outpatient procedure. It includes the complete removal of the breast tissue without removal of any lymph nodes.
Partial or Segmental Mastectomy
This procedure includes the complete removal of the tumor and a larger portion of surrounding breast tissue. This is considered a breast conserving surgery.
Modified Radical Mastectomy
This surgical procedure includes the removal of the breast tissue as well as all of the axillary lymph nodes. This procedure can be followed by immediate breast reconstruction which is performed by a plastic surgeon and may require hospitalization.
Sentinel Lymph Node Biopsy
This newer technique is a method in which the sentinel node or the “first node” that a tumor would spread to if it is going to spread can be identified with a radioactive tracer or blue dye. The tracer travels the same path to the lymph nodes that the cancer would follow. The doctor can then biopsy the most likely node(s) to be positive for cancer.
A portacath is intravenous access which is placed so that chemotherapy can be safely administered. It is placed near the collar bone into a large vein.
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