Breast surgery
Surgery to treat breast cancer ranges from breast-conserving surgery, such as a lumpectomy, to a partial or full mastectomy, which removes the entire breast. A lumpectomy removes the cancer and some of the surrounding breast tissue in order to obtain a clean margin of at least 2 millimeters. Lumpectomy typically is followed by additional treatment, such as radiation, chemotherapy or hormonal therapy.
Surgery also is performed to check the lymph nodes located under the arm, as this can determine if the cancer has spread. This procedure, sentinel lymph node biopsy, uses radiosensitive dye to determine if, and how many, lymph nodes are positive. The surgeon can then proceed appropriately in removing the first node (sentinel node). In some cases, all nodes under the arm must be removed, a procedure known as axillary lymph node dissection.
Breast reconstruction, which is performed by one of our skilled plastic surgery colleagues, often can be done during the initial surgery or after the course of treatment is complete.
Melanoma surgery
Melanoma is highly curable if detected early and can be removed via a same-day surgical procedure. Depending on the thickness of the melanoma—thicker than 1 millimeter—treatment may require surgery that includes sentinel lymph node biopsy. This involves injecting radiosensitive dye near the tumor; those lymph nodes that have changed color or look abnormal can then be removed. If more than three lymph nodes are found to be positive, some patients will need to have all lymph nodes in the area surgically removed. Sentinel node biopsy is the best way to determine whether or not the cancer has metastasized. It also helps obtain information for prognosis and decision-making about the need for additional treatment.
Venous access devices
A central venous access device, or CVAD, includes a catheter (a thin, flexible hollow tube) that is inserted into and positioned within a vein to deliver therapy to the bloodstream. A CVAD allows intravenous medications to be given easily and saves the patient from the discomfort of repeated needle sticks.
There are two general types of CVADs: catheters and ports. Catheters have one end positioned outside the body, while ports are surgically placed under the skin and require a special needle for access. With both catheters and ports, the opposite end of the tubing is positioned within the large vein near the heart.
