The Breast Center at Providence Hospital is a state-of-the art facility staffed by specially trained physicians and other caregivers from multiple specialties who are experts in the detection, diagnosis and treatment of breast cancer. Numerous resources are engaged to provide every patient with holistic care in a spiritually centered setting. Our emphasis is on the timely evaluation of the problem, rapid diagnosis and an optimal course of individualized treatment for women and men with breast disease.

 
     
Providence Hospital
MD Anderson
 

Surgical Services

Treatment for breast cancer at Providence Hospital is thoughtfully considered and carefully planned by our cancer experts to address the specific condition of each individual patient. Treatment options include surgery, medical oncology and radiation oncology.

Breast cancer surgery includes a variety of procedures:

  • Breast biopsy - surgical excision of all or a portion of a suspicious lump for diagnostic purposes.
  • Breast biopsy with needle localization - surgical excision of all or a portion of a suspicious lump that has been identified by a radiologist and marked with a flexible needle for location during surgery.
  • Breast conservation surgery – commonly known as a lumpectomy, it is the removal of only the lump and immediate surrounding tissue.
  • Mastectomy - removal of the entire breast. It may or may not include immediate reconstruction surgery.
  • Sentinel lymph node identification and biopsy with radioactive isotope and gamma detection – the identification of the primary lymph node(s) located in the axilla, or armpit, that drain(s) lymphatic fluid from the breast area. This procedure is used for determining the stage of the cancer.
  • Axillary node dissection - more extensive surgery to remove all lymph nodes in the armpit that drain the breast.

Many women choose to have breast reconstruction surgery following mastectomy. Reconstructive surgery includes the following procedures:

  • Breast augmentation with implants - artificial breast implants are placed to restore a natural looking breast mound.
  • Tissue-flap procedures – uses your own skin, fat and muscle from another part of your body to reconstruct the shape of your breast
  • Nipple/areola reconstruction – the nipple is reconstructed from surrounding skin once the breast reconstruction is completed and healed.

What to Expect if You’re Having Surgery

Before your surgery

Your doctor will perform a physical exam and take a history of your previous medical conditions, surgical procedures and medications that you currently take. You will need to give as much information as possible, including the names and dosage of any over-the-counter medications or herbal supplements that you take, and any allergies that you may have. Based upon this information, your doctor will order any lab work that is needed including blood and urine tests. Usually this can be done several days before your surgery to ensure that the results are back before the procedure.

The surgeon will discuss risks and benefits of your intended surgical procedure and answer any questions that you or your family members may have so that you can provide an informed consent for the procedure. An anesthesia provider will also discuss your physical status and previous medical history with you to plan the best anesthesia for your procedure and discuss the risks and benefits of the planned anesthesia care. Before surgery you will also meet with our Patient Care Coordinator to discuss the overall plan of your care and share information with you regarding support services that are available to you.

On the day of surgery

You will be given a time to report to the hospital, usually a few hours before your procedure.  Check in at Outpatient Registration in Building B.

  • It is important that you do not have any food, drink, tobacco substances, gum or candy after midnight the day before your surgery and during the day of surgery.
  • If you routinely take medication to control your blood pressure or diabetes, you may be instructed to take it as you normally would. These instructions will be outlined in your preoperative instructions.
  • Wear comfortable clothes to the hospital and plan to have someone drive you home after your procedure.
  • Bring any paperwork from the doctor’s office or lab with you to the hospital.
  • Please leave your valuables at home or have someone you can leave them with when you are taken into the prep area.

If you are scheduled to have a biopsy with needle localization, you will be taken to the Breast Center, where the radiologist will insert a small wire into your breast while taking radiographic imaging. The area will be numbed with anesthetic medication prior to the wire being inserted. The wire will be taped to your breast afterward to prevent it from dislodging. This will help the surgeon detect the proper location during the procedure.

If you are scheduled for sentinel node biopsy, you will be given an injection of radioactive tracer while in the Breast Center. The tracer combines with the lymphatic fluids in the breast that travel to the lymph nodes in the axilla and can be detected with a device the surgeon uses to locate the sentinel node. If you are going to have imaging after the injection, you will wait for 45 minutes and then have the image taken. These will assist the surgeon in identifying the sentinel node. The sentinel node is the first node that picks up the radioactive tracer. Identification of the sentinel node decreases the number of lymph nodes that have to be removed for staging the cancer. Staging is done to help determine an appropriate plan of care and treatment.

Once you are taken into the preoperative care area, you will be asked to change into a patient gown and your personal clothing will be placed in a plastic bag with your identification on it. (If you went to the Breast Center, this would have been done there.) Jewelry, hair clips, hair pins, eyeglasses, contact lenses and dentures must also be removed. You will be placed on a stretcher and an IV will be started in one arm. Your family members or significant others will be asked to go to the waiting area during this time and will be kept informed of your condition before, during and after surgery. Once your IV has been started and your medical information verified, you may be given a mild sedative to help ease any anxiety before the procedure.

During your surgery

You will be taken to one of the operative suites and transferred from your stretcher onto a surgical bed or table. You may or may not recall this period of time before the surgery, depending on your sedation. Monitors will be placed on your chest, arm and one finger to record your heart rate, blood pressure and level of oxygen. If you are to receive general anesthesia, this is the point in time where you will fall “asleep”. If you are being given monitored anesthesia care, then you will receive sedation and although you may still be able to respond to questions or feel a sensation of touch on your skin, you should not feel pain nor remember many of the details during this time.

After your surgery

When you awaken, you will have a soft surgical dressing and possibly a surgical bra on the affected breast area. Some patients will have a drain placed during surgery and this will be secured with tape. The post-anesthesia nurse will monitor your vital signs until you return to your pre-procedural state so that you may be released to go home or in some cases be admitted for overnight care. Patients who have a mastectomy will be kept overnight, if indicated.

You will be instructed on how to care for your surgical incision, how soon you may bathe or shower, and you will be given any prescriptions that may be needed after surgery. A follow-up visit will be scheduled with your surgeon. Your nurse will talk to you about potential complications and what might occur during your recovery that may be a cause for concern or follow-up, such as fever or redness at the operative site. A detailed list of instructions will be sent home with you for later reference if you have questions. You will also be provided with a telephone number to call if you have any concerns or further questions.

The Patient Care Coordinator will be in touch with you after surgery to offer educational support and connect you with additional services and resources available at Providence and throughout the community that may be helpful to you. She will also be available to answer any questions or concerns you or your family may have regarding additional treatment.

   
 

Dr. Alexander Blankenship
Dr. Alexander Blankenship

Dr. Ernest Burch
Dr. Ernest Burch

Dr. Daniel Burch
Dr. Daniel Burch

Dr. William Lightfoot
Dr. William Lightfoot

Dr. William Lightfoot
Dr. Jay Murray

Dr. Robert Willet
Dr. Robert Willett