Surgery

Surgeons Focus on Patient’s Individual Needs

At University Hospitals Ireland Cancer Center now University Hospitals Seidman Cancer Center, our breast surgeons focus on a woman’s individual needs with an emphasis on minimally invasive and breast-sparing procedures whenever possible. When looking for a surgeon, it is best to seek a physician who specializes in breast diseases. Generally, they are more up-to-date on the current literature and techniques used in breast cancer treatment and work with a multidisciplinary team to provide the most effective care.

Depending on the type and extent of the cancer, patients work with surgeons to choose between:

• Lumpectomy: A lumpectomy is a breast-conserving surgery involving removal of the tumor and some surrounding tissue.
• Mastectomy: A mastectomy is a removal of the breast.

During either type of surgery, a lymph node (or multiple nodes) may be removed to help determine the stage of cancer and subsequent treatment. Skin- and nipple-sparing mastectomies preserve patients’ breast skin while breast tissue beneath is removed.

Reconstructing Breasts for Cancer Patients

Surgeons removing cancerous tissue work hand-in-hand with plastic surgeons trained in the latest methods to rebuild the shape of the breast. Patients considering reconstructive surgery should discuss it with their doctor and an experienced plastic surgeon. University Hospitals plastic surgeons are experienced in all methods that attempt to restore breasts to their near-normal appearance, including:

• Implant reconstruction: After the breast surgeon removes the breast tissue, the plastic surgeon places a breast implant where the breast tissue was removed to form the breast contour.
• Tissue flap reconstruction: The surgeon creates the breast mound using the patient’s own tissue. This tissue remains healthy because it maintains its own blood supply. The two most common types of tissue flap surgeries are the TRAM flap (transverse rectus abdominis muscle flap), which uses tissue from the abdomen, and the latissimus dorsi flap, which uses tissue from the upper back.
• DIEP reconstruction: The doctor uses fat and skin from the same area as the TRAM flap procedure, but uses the DIEP (deep inferior epigastric perforator) to form the breast mound without transferring the muscle tissue. This procedure does not weaken the abdominal wall and decreases the chance of bulging and hernia formation. Our team is one of only a few surgical teams in the Midwest to regularly and successfully perform DIEP flap procedures.
• Nipple- and skin-sparing mastectomy: For this procedure, the surgeon removes all underlying breast tissue, but the outer skin and nipple are preserved. An implant replaces the breast tissue. This surgery can dramatically improve the breast’s appearance after a mastectomy.