Breast Cancer Surgery | Mastectomy, Reconstruction | MedStar Health
A doctor talks with a female patient in a clinical setting.

The latest state-of-the-art surgical treatments for breast cancer

At MedStar Health, we offer all of the diagnostic and breast cancer treatments you'd expect for men and women—plus some you might not. Treatment options are always supported or driven by the latest research and techniques in breast cancer surgery, including breast- and nipple-sparing procedures, and sophisticated reconstructive surgeries. 

Most of our programs are accredited by the National Accreditation Program for Breast Centers (NAPBC). And, many of our breast surgeons are recognized as "Top Docs" by Baltimore magazine and the Washingtonian. In addition, as a partner of the Georgetown Lombardi Comprehensive Cancer Center, one of only 51 National Cancer Institute-designated Comprehensive Cancer Centers in the country, we deliver advanced cancer treatments and are known for our efforts in patient care, cancer research, patient education, and community outreach.

Our approach

A team of specialists who treats you as a whole person, not just your disease

Breast cancer care is complex, which is why we involve specialists across a variety of disciplines in the design of a treatment plan that will lead to your best outcomes. Our breast surgeons meet regularly with radiation oncologists, medical oncologists, radiologists, reconstructive experts, genetic counselors at regularly-scheduled tumor boards to discuss breast cancer cases. This multidisciplinary approach ensures we think through every aspect of your care.

Your breast surgeon is typically the first person on your care team that you'll meet with after a diagnosis. When surgery is recommended to treat breast cancer, you can expect us to use the latest technologies and surgical approaches that carefully remove cancerous tumors while aiming to achieve the best appearance possible. In many cases, we can perform what's called breast-conserving surgery, which allows us to preserve the breast's form while matching its size as close as possible to the other side.

We understand that surgery for breast cancer can be emotional, and we'll help you explore all of your surgical and reconstructive options from the beginning. If you desire breast reconstruction, we work side-by-side with our colleagues in plastic surgery who can restore the natural appearance of your breast using implants or your own tissue.

Types of breast cancer surgery

Sentinel lymph node biopsy

Sentinel lymph node biopsy is surgery to identify, remove, and microscopically examine the lymph nodes directly in the pathway of spreading cancer cells. This allows us to assess whether breast cancer has spread to lymph nodes under your arm, which are the most likely lymph nodes to contain cancer.

Breast-conserving surgery: Lumpectomy

A partial mastectomy (often called a lumpectomy) is the most common form of breast cancer surgery. It is a surgical procedure to remove a tumor from within your breast and some tissue surrounding the tumor. It does not remove the entire breast, which is why it is considered a breast-conserving or -preserving surgery.

The breast size may be a bit smaller after a partial mastectomy. If needed, MedStar Health plastic surgeons will use oncoplastic techniques to restore symmetry and reduce the other side to match.

Following surgery, most women will have radiation therapy to reduce the risk of cancer returning. Chemotherapy, if needed, is initiated before the radiation treatment.

Oncoplastic techniques preserve your breast's appearance

During lumpectomy, our breast surgeons and plastic surgeons often work together to carefully remove tumors with attention to achieving the best appearance possible. Although oncoplastic surgery is more complex, our surgeons are experts in restoring symmetry and appearance—preserving the breast's form while matching its size as close as possible to the other side.

Mastectomies that spare the nipple and skin

If you have a larger tumor or several tumors throughout your breast, you may need a mastectomy to remove the entire breast and, in some cases, nearby tissue and lymph nodes.

You may also need a mastectomy if cancer returns after a lumpectomy and radiation. We strive not only to remove cancer entirely but also to do so in a way to minimize the physical, emotional, and psychological impact.

Our approaches include:

  • Scar avoidance: We use small incisions when possible to remove breast tissue.
  • Skin-sparing techniques: With the skin-sparing method, the nipple, areolar, and breast tissue underneath the skin is removed—an approach that has been shown not to increase the risk of cancer returning.
  • Nipple-sparing techniques: In select patients, we can leave the nipple and the areola complex intact to maintain your previous appearance as much as possible. You should discuss with your surgeon and plastic surgeon to see if you are a candidate for this procedure.

Immediate breast reconstruction

After a mastectomy, most women are candidates for breast reconstruction, and many choose to do so. Our well-trained plastic surgeons can restore a natural look through several approaches, many of which they pioneered or refined:

  • Autologous tissue flaps: Tissue is carefully taken from elsewhere in your body, usually from the back, stomach, thighs, and/or buttocks.
  • Implants: We mainly use a silicone-based gel, which won't leak even in the rare event of a rupture. We often start with a tissue extender, a balloon-like device that helps mold the right size and shape before the implant is placed.

The collaboration between our breast surgery experts and plastic surgeons allows us to offer immediate reconstruction after surgery, when appropriate. Many patients appreciate this approach, which provides the benefit of having two procedures during a single operation and a single dose of anesthesia.

Axillary lymph node dissection

The lymphatic system includes the nodes, tissues, and organs that produce and store infection-fighting white blood cells, as well as lymph, the fluid that circulates throughout this system. In a properly functioning lymphatic system, your lymph nodes filter out the lymph, eliminating bacteria and other waste products—including cancer cells.

If cancer cells begin to travel through the lymphatic system, they can end up in the lymph nodes; in cancers that start in the breast, the closest lymph nodes are in the armpit area—the axillary lymph nodes. If your doctor determines that your breast cancer has spread to these nodes, you will need an axillary dissection.

Most often, your surgeon will remove the Level I and II lymph nodes during this procedure. Generally, 45 lymph nodes are in the axilla, and, on average, 10-20 are removed during the operation.

A therapist performs lymphedema therapy on a patient.

Lymph node reconstructive surgery

When lymph nodes are removed during surgery, we're one of few health systems on the East coast to offer groundbreaking procedures to prevent and treat lymphedema.

Prophylactic mastectomy (preventative surgery)

If you have a significant family history of breast cancer or carry the BRCA1 or BRCA2 gene mutations, you may consider having an elective mastectomy, known as a prophylactic, preventive, or risk-reducing procedure. This surgery removes your breast(s) to decrease the chance you will develop cancer.

While many women appreciate the opportunity to participate personally in reducing their risk, a prophylactic mastectomy does not guarantee you will avoid breast cancer. Other potential consequences to consider include:

  • The surgery is irreversible
  • You cannot breastfeed from a reconstructed breast
  • Reconstructed breasts lose feeling and sensitivity
  • Some women experience changes in the way they feel about their body image

Our breast surgery specialists help you determine whether this approach best suits your situation and needs. If you decide to pursue this option after careful consideration, we offer you the best care available in an atmosphere designed to put you at ease.

Looking for expert cancer care ?

With multiple locations throughout the region, patients have access to many of the nation’s renowned cancer specialists offering high quality care, second opinions and a chance for better outcomes close to where they live and work. Georgetown Lombardi Comprehensive Cancer Center, one of the nation’s comprehensive cancer centers designated by the National Cancer Institute (NCI), serves as the research engine allowing patients access to clinical trials that often lead to breakthroughs in cancer care.

Our locations

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MedStar Health: Betty Lou Ourisman Breast Health Center at MedStar Georgetown University Hospital

3800 Reservoir Rd., NW
Georgetown Lombardi Comprehensive Cancer Center
Ground Floor
Washington, DC 20007

MedStar Health: Breast Health Program at MedStar Washington Hospital Center

110 Irving St. NW
Washington Cancer Institute
1st Floor
Washington, DC 20010

MedStar Health: Breast Center at Bel Air

12 MedStar Blvd.
Ste. 180
Bel Air, MD 21015

MedStar Health: Breast Center at MedStar Good Samaritan Hospital

5601 Loch Raven Blvd.
Smyth Building
Suite 403B
Baltimore, MD 21239

MedStar Health: Breast Health Program at Lafayette Centre

1133 21st St., NW
Bldg. 2
Ste. 800
Washington, DC 20036

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