Breast Surgery

Treatment of Benign and Malignant Conditions

Beginning 25 years ago, Arhtur Glasgow championed the idea of doing breast conserving surgery at Norwood hospital. That meant doing lumpectomies whenever possible rather than mastectomies. He also promoted the techniques of using local anesthesia and intravenous sedation for surgical breast biopsies, of using absorbable sutures that are placed under the skin to minimize scarring, and of not using drains in surgical biopsies. These techniques Adam and Arthur still use. Women who have lumps that can be palpated or felt often are biopsied by fine needle aspiration which can be done in the office with a small amount of local anesthesia. Lumps which are cysts may be drained and eliminated by such aspirations. Lumps which are detected by mammogram or ultrasound are referred to the radiologists for imaging guided needle biopsies.

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Sentinel Node

In women younger than age 75 with invasive breast cancer, we do sentinel node biopsies to determine if the cancer has spread to the lymph nodes under the arm. This involves a small incision near the underarm through which one, or just a few lymph nodes are removed. These nodes are called sentinel nodes because they are the first node or nodes to which cancer might spread. They are identified by using dyes and minimally radioactive tracers injected in the breast. If the sentinel node is negative, and this may be determined by a "frozen section" immediate pathological examination, then no further lymph nodes have to be removed. This results in many fewer problems than when an axillary (underarm) dissection is done.

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