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Advancements in Breast Surgery and Cancer Treatments
October 20, 2020
The breast surgeons at Weill Cornell Medicine are never fully satisfied. They thrive on new opportunity, innovation, and flexibility to combat breast cancer. And they collaborate closely with the specialists that make their work possible—in medical oncology, radiology, and plastic surgery—helped patients medically, made them happier, and, most important, made survivorship possible.
“The surgical aspects of innovation are to a point where we can now talk about life after breast cancer,” says Alexander Julian Swistel, MD, associate professor of clinical surgery and associate attending surgeon at NewYork-Presbyterian/Weill Cornell Medical Center.
Using skilled, thoughtful approaches, Weill Cornell Medicine has pioneered procedures that reduce post-surgical pain, preserve more of the patient’s own breast, and are generally less invasive.
For as long as David M. Otterburn, MD, FACS, associate professor of surgery in the Division of Plastic and Reconstructive Surgery in the Department of Surgery at Weill Cornell Medical College, had been performing breast reconstruction, he has fielded patients’ understandable complaints about the uncomfortable, cumbersome drains they had to manage after surgery.
For the last two years, he’s been performing breast reconstruction using tissue expanders that no longer require drains, which had been used to wick away fluids that build up after surgery. Patient sundergoing the drainless procedure are experiencing fewer complications, fewer infections, and are more comfortable.
“Patients love it,” Dr. Otterburn says. “When patients find each other on social media and in support groups, and they talk about not having drains, other patients can’t believe it. Drains might seem minor to the surgeon, but they aren’t to the patient.”
Dr. Otterburn also has been a regional leader in the use of the DIEP breast reconstruction surgery, which transplants excess living fat from below the belly button to the chest, to give breasts more natural shape and volume.
“As far as being a natural breast and patient satisfaction, this has been very successful,” Dr. Otterburn says. “We’re replacing the breast with the patient’s own tissue, so it looks, feels, and even ages like a natural breast.”
Weill Cornell Medicine surgeons also have been reconnecting nerve tissue in the breasts, restoring the sensation that many patients lose after mastectomy.
“Patients feel like the breasts are truly their own, and they can move beyond this chapter in their lives—they can feel hugs again.”
Dr. Swistel points to partial breast irradiation as another surgical success for Weill Cornell Medicine patients. This procedure can help women in early stages of breast cancer who undergo a lumpectomy to remove the cancerous tumor, as opposed to removing the entire breast, followed by carefully targeted radiation.
“Now there’s no potential damage to the heart and lungs, we’re not disrupting the immune system, and women have a shorter time commitment for their treatment,” Dr. Swistel says.
Some patients are able to undergo skin-sparing mastectomies to preserve more of their own breast skin, if tumors aren’t located too close to the skin. This allows the surgeon to remove only certain parts of the patient’s breast skin—enough to remove breast tissue through a small incision—and ultimately use what remains as a form to accommodate an implant or reconstruction.
Nipple-sparing mastectomy is an extension of the skin-sparing surgery. The surgeon can remove all of the glandular breast tissue through a small incision beneath the breast, leaving the full breast skin envelope and nipple intact. Surgeons can begin reconstruction at the same time with either and implant or natural tissue.
Weill Cornell Medicine’s patients also are benefiting from a procedure using a small, single incision under the patient’s arm to remove breast cancer tumors and nearby affected sentinel nodes. Sometimes radiation can be performed at the same time.
“We’ve brought not only innovation to this program, but the personalization of care. We are willing to try new ideas and approaches,” Dr. Swistel says, which makes patients feel truly cared for. “Sometimes the fact that the patient is special gets lost—but individualized care is the highlight of our program.”