Breast Surgery

A breast cancer diagnosis can be life-changing, but at the Breast Center at Weill Cornell Medicine, patients never go through it alone.

Our supportive network of physicians, nurses and support staff are dedicated to providing comprehensive and personalized care to patients with all stages of breast cancer, as well as those at risk for developing the disease.

Patients receive expert and compassionate care in a serene setting at the Breast Center, one of only two centers in New York City accredited by the National Accreditation Program for Breast Centers.

Our physicians specialize in all aspects of breast cancer treatment, from breast and reconstructive surgery to oncology, radiology, pathology and genetic testing. They are recognized leaders in the field and experts in various aspects of the disease, including some of the most aggressive and hard-to-treat breast cancers such as triple negative breast cancer.

Additionally, our physicians have been at the forefront of many of the techniques used in standard practice today. The Breast Center leverages this expertise twice weekly during breast cancer tumor boards, where our physicians come together to review each patient’s case and determine the best treatment options.

We offer a full range of breast cancer services such as lumpectomy, sentinel lymph node biopsy, preventative measures such as genetic risk assessments, as well as cutting-edge chemotherapy and immunotherapy treatments, and surgical procedures such as intraoperative (INTRABEAM) radiation therapy.

We also offer clinical trials, which can provide new and innovative therapies for all stages of breast cancer such as freezing tumors with cryotherapy.

The Breast Center also provides several services to address the physical and emotional stresses that can accompany breast cancer. Our cold cap program, the largest in New York City, helps prevent hair loss in chemo patients. We also offer educational seminars and complimentary yoga and mediation services.

For more information about our services or to request an appointment, contact us today.

Our breast surgery program offers holistic, complementary care services to our patients and families. Led by registered nurse and yoga instructor Fran Conway, these therapies address patients’ wellbeing and are provided at no additional cost.

Fran believes a person’s expectations and attitudes have a significant impact on their wellbeing and encourages patients to incorporate meditation, gentle yoga, breathing practices and relaxation exercise to help improve their outlook on their conditions, treatments and daily lives. Through her practice, she aims to help them navigate their individual healing processes.

Fran offers several complimentary workshops, including:

• Prepare for Surgery – This workshop addresses the patient’s concerns while preparing for surgery, radiation or chemotherapy. The five-step process includes the use of visualization to turn worries into positive healing energy, organizing a support group of family and friends, and using healing statements during surgery.

• Reiki – The hands-on, spiritual healing practice aims to reduce pain and lessen anxiety

• Gentle Therapeutic Yoga – Sessions incorporate relaxing poses that are completely adaptive to any level of fitness, ages or gender

• Breathing Exercises – Learn a series of breath work that can dramatically shift your mood within sixty seconds

• Meditation – Practice the art of being still and being in a state of relaxed, but heightened awareness

Workshops are offered on Tuesdays and Thursdays, although private, one-on-one sessions are also available. Please see the schedule below for session availability.

To learn more about the workshops or to schedule an appointment, please contact Fran at (212) 746-5360 or frs2005@med.cornell.edu.

Workshop Schedule

Tuesdays

3:30 p.m. to 4:30 p.m. — Gentle Yoga
4:30 p.m. to 5:30 p.m. — Private Individual Session

Thursdays

9:00 a.m. to 10:00 a.m. — Peggy Huddleston’s Prepare for Surgery Technique
10:00 a.m. to 11:00 a.m. — Gentle Yoga
11:00 a.m. to 12:00 p.m. — Private Individual Session
12:00 p.m. to 1:00 p.m. — Private Individual Session

Approximately 7 to 10 percent of breast and ovarian cancers occur because an inherited gene mutation is transmitted from parent to child. This mutation, known as a BRCA mutation, raises the risk of developing these diseases significantly; according to some experts, those with this mutation have an 85 percent chance of developing breast cancer.

If you have a family history of breast or ovarian cancer, genetic counseling and testing can help you make informed decisions about your health and your family’s wellbeing.

Initial Phone Conversation

At the Weill Cornell Breast Center, patients will often call for a consult with the Genetic Risk Assessment Program at the time of a breast cancer diagnosis, particularly if they have a family member who has had breast or ovarian cancer.

"One of the most important times to call our program is when you are first diagnosed with breast cancer because if you test positive for a BRCA mutation, you might change your surgery options," said Ann Carlson, a genetic counselor at Weill Cornell Medicine.

"For some women, this is an important piece of information in the decision-making process. People also tend to call us when a new breast cancer or ovarian cancer has been diagnosed in their family, which tips their level of concern to the point where they're very concerned. It may be the second or third such diagnosis in the family."

Calls that come into the Genetic Risk Assessment Program are answered directly by Ms. Carlson. If the patient is newly diagnosed, she can often schedule an on-site consultation for the same day, especially if a decision about surgical treatment is pending. The initial phone conversation may be 20 to 30 minutes during which time Ms. Carlson determines if genetic testing may be indicated and answers any questions.

"A call is not a commitment to further pursue genetic counseling or testing — it's an exploratory discussion to help guide the caller," she said.

First Appointment

Once a patient decides to have testing, an appointment is scheduled. A typical session starts with outlining the patient's family tree, emphasizing who in the family has had cancer, what type of cancer, and the age at time of diagnosis.

"Using the pedigree format rather than a straight list enables us to detect patterns of cancer in the family," Ms. Carlson explained.

The discussion also includes an explanation of BRCA genes and what it means to test positive for a BRCA mutation. It is important to note that everyone has the BRCA genes (BRCA-1 and BRCA-2), but it is the mutation of the gene(s) that is predictive for breast cancer.

"I always tell a patient what risks they would have if they carry a BRCA mutation, what options they have in terms of managing that risk, and the implications for other family members if they test positive," said Ms. Carlson.

Genetic Testing

Testing for the BRCA mutation is done either with a blood test or a saliva test, whichever the patient prefers. With the saliva test, a patient cannot eat, chew gum or drink (except water) for an hour before the test. A blood or saliva sample is collected at the end of the first appointment. Results of testing are available within two weeks.

If a patient tests negative for BRCA 1 and BRCA 2, but has a high risk for developing cancer due to other factors such as family history of cancer, there are now available 14 other genes related to breast cancer for which they can be screened. Patients will be advised whether they should consider this additional testing.

Genetic Counseling

If the patient tests positive for a BRCA mutation, an appointment is scheduled with Ms. Carlson, our genetic counselor. She discusses what testing positive means for that particular patient, provides detailed information about her risk of developing cancer and explains the options available for lowering that risk.

Patients who have been diagnosed with breast cancer and test positive for a BRCA mutation may consider proceeding with a bilateral mastectomy rather than a lumpectomy or removal of the affected breast.

For those who test positive but do not have a diagnosis of breast cancer, the providers will generally advise on increased screening, which makes it possible to make the earliest diagnosis should breast cancer develop. They may also recommend certain medications to considerably lower the risk of ovarian cancer, or, recommend removing the ovaries.

With the Genetic Information Nondiscrimination Act of 2008 (GINA), which prohibits discrimination in health coverage and employment based on genetic information, patients who test positive do not need to worry about discrimination by health insurers or their employers.

For More Information

For more information about the Weill Cornell Breast Center's Genetic Risk Assessment Program, please call (212) 821-0833.