At the Breast Center at Valley View, we strive to treat each breast cancer
patient with personalized attention. Our multidisciplinary team of surgeons
and Calaway•Young Cancer Center oncologists will meet with you to
determine your specific cancer type and stage and then develop a treatment
plan following the latest standards of care. We are dedicated to providing
you follow-up care and will help navigate you through survivorship to
maximize your life after cancer.
We are part of the accredited Calaway•Young Cancer Center at Valley
View and follow strict guidelines from the Commission on Cancer. Our multidisciplinary
team meets weekly to discuss our new patients, review their diagnostic
studies and obtain consensus on the best treatment options. Our team of
experts uses their experience and knowledge to help you through your diagnosis.
Our approach to breast cancer is more than just treatment. The Breast
Center offers genetic testing and counseling for women with a family history
of breast cancer. Your care team includes our skilled plastic surgeon,
Dr. Jennifer Butterfield, who will make you feel like yourself again with
the latest breast reconstruction procedures. We know this is a scary time
filled with confusion, anxiety and fear. We are here to help.
NURSE NAVIGATION
Oncology Nurse Navigators help patients navigate the system to ensure prompt
delivery of treatment and transition back into a normal routine after
treatments have finished. Our nurse navigators serve as a resource for
teaching patients about their disease and side effects from treatments.
They also empower patients to overcome barriers to care and can help patients
and access the many resources available in this valley. By working with
an oncology nurse navigator, patients and their families can receive the
following benefits:
Decreased time between diagnosis and treatment
Assistance with coordinating appointments between patients, families and
physicians
Additional support to help reduce stress and anxiety
Arranging language translation or interpretation services
Referrals to social services available at the hospital and in the valley
Personalized continuing education about disease, treatments and side effects
Encouragement for making healthy choices for nutrition, exercise, and quality of life
Improvement of treatment compliance, better outcomes, and patient satisfaction
BREAST CANCER SURGERY
There are two main types of surgery to remove breast cancer:
Breast-conserving surgery (also called a lumpectomy, quadrantectomy, partial mastectomy, or segmental
mastectomy) is a surgery in which only the part of the breast containing
the cancer is removed. The goal is to remove the cancer as well as some
surrounding normal tissue. How much breast is removed depends on where
and how big the tumor is, as well as other factors.
Mastectomy is a surgery in which the entire breast is removed, including all of the
breast tissue and sometimes other nearby tissues. There are several different
types of mastectomies. Some women may also get a double mastectomy, in
which both breasts are removed.
CHOOSING BETWEEN BREAST-CONSERVING SURGERY AND MASTECTOMY
Many women with early-stage cancers can choose between breast-conserving
surgery (BCS) and mastectomy. The main advantage of BCS is that a woman
keeps most of her breast. But in most cases she will also need radiation.
Women who have mastectomy for early-stage cancers are less likely to need
radiation.
For some women, mastectomy may be a better option, because of the type
of breast cancer, the large size of the tumor, previous treatment with
radiation, or certain other factors.
Some women might worry that having a less extensive surgery might raise
their risk of the cancer coming back. But studies following thousands
of women for more than 20 years show that when BCS is done with radiation,
survival is the same as having a mastectomy in people who are candidates
for both types of surgery.
SURGERY TO REMOVE NEARBY LYMPH NODES
To find out if the breast cancer has spread to underarm (axillary) lymph
nodes, one or more of these lymph nodes will be removed and looked at
in the lab. This is an important part of figuring out the stage (extent)
of the cancer. Lymph nodes may be removed either as part of the surgery
to remove the breast cancer or as a separate operation.
The two main types of surgery to remove lymph nodes are:
Sentinel lymph node biopsy (SLNB) is a procedure in which the surgeon removes only the lymph node(s) under
the arm where the cancer would likely spread first. Removing only one
or a few lymph nodes lowers the risk of side effects from the surgery,
such as arm swelling that is also known as lymphedema.
Axillary lymph node dissection (ALND) is a procedure in which the surgeon removes many (usually less than 20)
underarm lymph nodes. ALND is not done as often as it was in the past,
but it might still be the best way to look at the lymph nodes in some
situations.
Breast Reconstruction
Breast reconstruction surgery is now considered an important step in the
recovery process following a mastectomy. Dr. Butterfield provides Basalt
area women the opportunity to restore their breasts to a natural appearance
through breast reconstruction, allowing them to regain their self-confidence
and once again feel comfortable in their own skin. Planning for this procedure
often begins at the time of cancer diagnosis when a treatment plan is
being developed. Dr. Butterfield will work with the cancer surgeon towards
a mutual goal in order to meet the specific needs of the patient.
During the first consultation to discuss breast reconstruction surgery,
it is important for patients to disclose where they are in the treatment
process and which cancer surgeon provided treatment. Our office will require
patients to provide any necessary pathology reports. The reconstruction
process may take place in multiple steps if the breast tissue needs to
be stretched to make room for implants. This discovery phase will help
guide the reconstruction process so patients end up with a new breast
that is the size, shape and look they want.
Each reconstruction technique will be tailored according to the patient’s
physical health, aesthetic goals, and personal preferences. There are
many factors playing into the approach that will be taken. The ultimate
goal is to ensure the patient is healthy and happy with their final breast results.
There are two primary categories of breast reconstruction techniques:
Procedures that involve using a breast implant
Procedures that are autologous (use the patient’s own body’s
tissue to reconstruct and recreate the breast)
Breast reconstruction using silicone or saline implants is a common approach
that generally starts with the use of a tissue expander to help form a
suitable pocket for an implant. The expander may be inserted after the
mastectomy procedure or during the same operative session. Over the course
of several months, the expander will slowly be enlarged using a sterile
solution injected through a port residing under the skin. During the scheduled
reconstruction surgery, the expanders are removed and replaced with permanent implants.
If there is limited tissue inside the breast, or limited skin on the outside,
tissue may be used from another part of the patient’s body to supplement
this loss. The most common areas to support this process are the buttocks,
thigh or abdomen. This is an autologous approach to breast reconstruction.
The TRAM flap (Transverse Rectus Abdominus Myocutaneous), the DIEP flap
and SIEA flap techniques involve taking skin and fat from the abdomen
and relocating it to the breast. The latissimus dorsi flap is another
common method using tissue from the patient’s back.
During a mastectomy, the nipple and areola often cannot be saved. The loss
of one’s nipple and areola can be as unnerving as the removal of
the breast itself. However, reconstruction techniques have advanced greatly,
allowing plastic surgeons the opportunity to recreate these areas of the
breast to give a natural, aesthetically appealing appearance. In a separate
procedure, the nipple is created using existing breast skin or from the
abdominal or latissimus flap. Using a tattoo technique, the areola is
recreated with a skin graft taken from the thigh, abdomen or back.
SURVIVORSHIP
Many changes occur after being diagnosed with cancer, and sometimes it
can be hard to get a sense of direction. The survivorship program is designed to give
you support during and after cancer. We offer a variety of services designed
to help answer your questions, learn new skills, find social support,
and live your best life every day.
Every patient of the Calaway•Young Cancer Center is scheduled for
an individualized session with one of our providers to discuss important
factors of cancer survivorship, including:
Details of your cancer diagnosis and treatment.
Information about proper surveillance for cancer recurrence.
Recommendations for diet, exercise, and other lifestyle changes to reduce
your risk of cancer and improve your quality of life.
Management of any ongoing symptoms or side effects of cancer treatment.
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