Intermountain Cancer Centers offer comprehensive state-of-the-art screening, diagnosis, and treatment for breast cancer. Diagnostic mammogram, ultrasound, breast tomosynthesis, percutaneous breast biopsy, and/or breast MRI are used to detect and diagnose cancer, and upon diagnosis patients are referred to a team of board certified breast cancer specialists including surgeons, medical oncologists, and radiation oncologists as well as plastic surgeons for reconstructive procedures.
This multidisciplinary team meets weekly to discuss treatment options based on national guidelines and clinical trials. All breast cancer patients receive individualized patient navigation, lymphedema assessment, and genetic counseling when appropriate.
Treatment and Procedures
The goal of surgery for breast cancer is to remove the cancer as well as a rim of normal tissue to be sure all the cancer is removed. Breast-conserving surgery, also called lumpectomy or partial mastectomy, involves resection of the cancer by removing only part of the breast; however, the amount of breast that is removed depends on the size and location of the tumor, previous treatment history, and other factors. In most cases, with breast conserving surgery, radiation is also needed to the breast.
Mastectomy removes the entire breast, usually including the nipple, but not always. When mastectomy is done, usually no radiation is needed, but can be recommended if there is a large amount of cancer, or if the cancer has spread to lymph nodes. A double mastectomy is the removal of both breasts.
In addition to surgery to get rid of the cancer in the breast, the lymph nodes in the axilla (armpit) are evaluated at the time of surgery to see if there is any spread of cancer cells. Routinely this is done with a sentinel lymph node biopsy where a few nodes are removed from the axilla for evaluation. Sometimes more lymph nodes are removed if there has been spread of cancer to the lymph nodes (axillary dissection).
At Intermountain, breast cancer surgery often also incorporates reconstructive surgery to restore the breast’s appearance after surgery. Consultation with our plastic surgery team will help determine the options including whether it should be performed at the same time as mastectomy (immediate reconstruction) or at another, later time (delayed reconstruction). Skin- and nipple-saving techniques can be used during mastectomy. We also offer reconstruction techniques for lumpectomy patients to help preserve breast tissue, but maintain a normal breast shape.
Flap reconstructions use a flap of complete tissue—blood vessels, skin, and fat—as donor tissue to reconstruct the breast. Flap reconstructions offered at Intermountain include DIEP (deep inferior epigastric artery perforator; from a woman’s lower abdomen), SGAP (superior gluteal artery perforator; from the upper buttocks and/or hips), and a muscle latissimus flap (from the back). Implant-based reconstruction and oncoplastic reconstruction are also offered, as well as fat-grafting.
Our plastic surgeons also offer surgical options to correct lymphedema, a buildup of lymphatic fluid in the fatty tissues under the skin that can occur in the arm, breast, and chest after breast treatment.